Machado Calixto, Perez Jesus, Scherle Claudio, Areu Alejandro, Pando Alejandro
Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba.
Ann Indian Acad Neurol. 2009 Jul;12(3):197-200. doi: 10.4103/0972-2327.56326.
The apnea test is a mandatory examination for determining brain death (BD), because it provides an essential sign of definitive loss of brainstem function. However, several authors have expressed their concern about the safety of this procedure as there are potential complications such as severe hypotension, pneumothorax, excessive hypercarbia, hypoxia, acidosis, and cardiac arrhythmia or asystole. These complications may constrain the examiner to abort the test, thereby compromising BD diagnosis. Nevertheless, when an appropriate oxygen-diffusion procedure is used, this technique is safe. We review here the prerequisites to begin the test, its procedure, potential complications, and the use of alternative ancillary tests. We recommend that the apnea test be retained as a mandatory procedure for the diagnosis of BD. In those situations when the apnea test is terminated by the examiner for some reason or when it is impossible to carry it out in a patient due to the presence of some pathologic condition, alternative ancillary tests should be used to confirm BD.
apnea试验是判定脑死亡（BD）的一项强制性检查，因为它提供了脑干功能确实丧失的一个重要体征。然而，一些作者对该检查的安全性表示担忧，因为存在诸如严重低血压、气胸、过度高碳酸血症、缺氧、酸中毒以及心律失常或心搏停止等潜在并发症。这些并发症可能迫使检查者中止试验，从而影响BD的诊断。尽管如此，当采用适当的氧弥散程序时，该技术是安全的。我们在此回顾开始该试验的先决条件、其操作过程、潜在并发症以及替代辅助检查的应用。我们建议将apnea试验保留为诊断BD的一项强制性程序。在因某些原因检查者终止apnea试验的情况下，或者在患者因存在某些病理状况而无法进行该试验的情况下，应使用替代辅助检查来确认BD。
