Ventilator autotriggering: a caution in brain death diagnosis.

The Uniform Determination of Death Act and the American Academy of Neurology's Guidelines for Determination of Death define procedures for diagnosis of brain death before organ procurement for transplantation, including clinical assessment and apnea test. Autotriggering of mechanical ventilators can occur in both brain dead and living patients. A case is reported in which procurement was delayed because ventilator self-cycling was confused for brainstem-mediated respiratory effort. Background knowledge to effectively troubleshoot ventilator self-cycling is offered so that unnecessary delays in brain death testing can be avoided.