Abstract

FERNANDEZ CEBALLOS, Ignacio et al. Pulmonary strain and end-expiratory lung volume during apnea test: a comparative analysis using electrical impedance tomography. Medicina (B. Aires) [online]. 2024, vol.84, n.2, pp.359-363. ISSN 0025-7680.

The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the pa tient from invasive mechanical ventilation (iMV) for ap proximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2. Common complications include hypoxemia and hemodynamic instability, and lung collapse-induced reduction in end-expiratory lung volume (EELV).

In our case series utilizing electrical impedance to mography (EIT), we observed that continuous positive airway pressure during the apnea test (CPAP-AT) effec tively mitigated lung collapse. This resulted in improved pulmonary strain compared to the disconnection of iMV. These findings suggest the potential benefits of routine CPAP-AT, particularly for potential lung donors, emphasizing the relevance of our study in providing quantitative insights into EELV loss and its association with pulmonary strain and potential lung injury.

Keywords : Electrical impedance tomography; Brain death; Apnea test; Continuous positive pressure airway.

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