Sara Hocker1, Francis Whalen, Eelco F M Wijdicks. 1. Division of Critical Care Neurology, Mayo W8-B, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA, hocker.sara@mayo.edu.
Abstract
INTRODUCTION: A 42-year-old man with a subarachnoid hemorrhage complicated by anoxic brain injury, respiratory failure requiring mechanical ventilation, and severe acute respiratory distress syndrome (ARDS) presented a clinical conundrum for safe apnea testing in brain death determination due to profound hypoxemia. METHODS: Case report. RESULTS: During brain death examination, despite meeting criteria for severe ARDS, apnea testing was successfully completed with the use of a pretest recruitment maneuver and 20 cm H(2)O CPAP valve. CONCLUSION: A recruitment maneuver and CPAP valve may be used in severe ARDS for safe apnea testing in brain death determination.
INTRODUCTION: A 42-year-old man with a subarachnoid hemorrhage complicated by anoxic brain injury, respiratory failure requiring mechanical ventilation, and severe acute respiratory distress syndrome (ARDS) presented a clinical conundrum for safe apnea testing in brain death determination due to profound hypoxemia. METHODS: Case report. RESULTS: During brain death examination, despite meeting criteria for severe ARDS, apnea testing was successfully completed with the use of a pretest recruitment maneuver and 20 cm H(2)O CPAP valve. CONCLUSION: A recruitment maneuver and CPAP valve may be used in severe ARDS for safe apnea testing in brain death determination.
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