Sahu Manoj Kumar, Vaswani Prateek, Bipin Chalattil, Singh Sarvesh Pal, Hadda Vijay
Intensive Care for CTVS, Department of CTVS, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, Room No. 5, 7th Floor, Ansari Nagar, New Delhi, 110029 India.
Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India.
Indian J Thorac Cardiovasc Surg. 2021 Mar;37(2):188-191. doi: 10.1007/s12055-020-01008-w. Epub 2020 Sep 1.
Coma, absent brain stem reflexes, and apnea are considered the neurological criteria of brain death. As membrane oxygenator does almost entire gas exchange in patients with severely diseased lungs who are on extracorporeal membrane oxygenation (ECMO), it is not possible to carry out apnea test in routine manner. We described the difficulties we faced conducting the apnea test and the other ancillary tests in our patient on veno-venous ECMO who suffered a major cerebral insult and reviewed the literature of brain death testing in patients on ECMO.
昏迷、脑干反射消失和呼吸暂停被视为脑死亡的神经学标准。由于膜式氧合器几乎承担了接受体外膜肺氧合（ECMO）治疗的重症肺病患者的全部气体交换功能，因此无法以常规方式进行呼吸暂停试验。我们描述了在接受静脉-静脉ECMO治疗且发生严重脑损伤的患者中进行呼吸暂停试验和其他辅助检查时所面临的困难，并回顾了有关ECMO患者脑死亡检测的文献。
