Articles: apnea-diagnosis.
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Episodes of apnea, desaturation, and bradycardia are common in preterm infants. Such infants who have persistent cardiorespiratory events detected by clinical bedside monitoring often are referred for overnight apnea monitoring studies. ⋯ Infants referred for apnea monitoring studies because of persistent bedside monitor alarms have very infrequent prolonged apnea but a higher frequency of desaturation and bradycardia in response to short respiratory pauses than infants without persistent bedside monitor alarms. Referral infants also exhibit a lower baseline Sao2. These abnormalities in oxygenation and cardiorespiratory control may be markers for subtle residual lung disease or functional central nervous system abnormalities.
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Ann Fr Anesth Reanim · Apr 2001
Case Reports[Barotrama during apnea testing for the determination of brain death].
We describe three cases of tension pneumothorax occurring during apnea testing for the determination of brain death. Every case needed needle thoracostomy for emergency chest deflation and/or a chest tube to be inserted rapidly. ⋯ This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the third patient and consequently loosing the pulmonary graft. Limitation of oxygen insufflation up to 8 L.min-1 with a 12 F oxygen supply tubing inserted within 5 cm into the endotracheal tube should be recommended to avoid this iatrogenic complication.
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Apnea test is a crucial requirement for determining the diagnosis of brain death (BD). There are few reports considering clinical complications during this procedure. We describe a major complication during performing the apnea test. ⋯ However, it is not innocuous and caution must be take in particular clinical situations. Complications during the apnea test could be more frequent than reported and may have practical and legal implications. Further prospective studies are necessary to evaluate the frequency and nature of complications during this practice.