Michael D Sharpe1, G Bryan Young, Chris Harris. 1. Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London Health Sciences Centre-University Campus, London, Ontario, Canada. michael.sharpe@lhsc.on.ca
Abstract
INTRODUCTION: Problems associated with the standard apnea test relate to overshooting or undershooting the target PaCO2, potentially compromising the viability of organs for transplantation or invalidating the test. MATERIALS AND METHODS: In 60 adult patients, the authors used an alternative method using exogenously administered CO2 and measurement of end-tidal CO2. RESULTS: All patients achieved an adequate respiratory stimulus (mean increase in PaCO2 was 28+/-3 mmHg, postapnea test pH was 7.20+/-.02). There was a clinically insignificant reduction in arterial blood pressure during testing, but no other complications occurred. Multiple regression analysis demonstrated a correlation between the predicted PaCO2 (predicted from the end-tidal CO2) and measured PaCO2 (64+/-9 versus 67+/-9; r=.75169, p<0.0001). CONCLUSION: Exogenously administered CO2 as an alternative method for the standard apnea test was a reliable and safe method, with minimal complications that offers several advantages over the standard method.
INTRODUCTION: Problems associated with the standard apnea test relate to overshooting or undershooting the target PaCO2, potentially compromising the viability of organs for transplantation or invalidating the test. MATERIALS AND METHODS: In 60 adult patients, the authors used an alternative method using exogenously administered CO2 and measurement of end-tidal CO2. RESULTS: All patients achieved an adequate respiratory stimulus (mean increase in PaCO2 was 28+/-3 mmHg, postapnea test pH was 7.20+/-.02). There was a clinically insignificant reduction in arterial blood pressure during testing, but no other complications occurred. Multiple regression analysis demonstrated a correlation between the predicted PaCO2 (predicted from the end-tidal CO2) and measured PaCO2 (64+/-9 versus 67+/-9; r=.75169, p<0.0001). CONCLUSION: Exogenously administered CO2 as an alternative method for the standard apnea test was a reliable and safe method, with minimal complications that offers several advantages over the standard method.
Authors: J M Dominguez-Roldan; J M Barrera-Chacon; F Murillo-Cabezas; J L Santamaria-Mifsut; V Rivera-Fernandez Journal: Transplant Proc Date: 1999-09 Impact factor: 1.066