Detection of spontaneous breathing during an apnea test in a patient with suspected brain death using electrical impedance tomography: a case report.
Apnea test
Atelectasis
Brain death
Case report
Electrical impedance tomography
Monitoring
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
16 Sep 2024
16 Sep 2024
Historique:
received:
25
07
2024
accepted:
10
09
2024
medline:
17
9
2024
pubmed:
17
9
2024
entrez:
16
9
2024
Statut:
epublish
Résumé
The apnea test (AT) is a crucial procedure in determining brain death (BD), with detection of spontaneous breathing efforts serving as a key criterion. Numerous national statutes mandate complete disconnection of the patient from the ventilator during the procedure to open the airway directly to the atmosphere. These regulations mandate visual observation as an exclusive option for detecting breathing efforts. However, reliance on visual observation alone can pose challenges in identifying subtle respiratory movements. This case report presents a 55-year-old morbidly obese male patient with suspected BD due to cerebral hemorrhage undergoing an AT. The AT was performed with continuous electrical impedance tomography (EIT) monitoring. Upon detection of spontaneous breathing movements by both visual observation and EIT, the AT was aborted, and the patient was reconnected to the ventilator. EIT indicated a shift in ventilation distribution from the ventral to the dorsal regions, indicating the presence of spontaneous breathing efforts. EIT results also suggested the patient experienced a slow but transient initial recovery phase, likely due to atelectasis induced by morbid obesity, before returning to a steady state of ventilatory support. The findings suggest EIT could enhance the sensitivity and accuracy of detecting spontaneous breathing efforts, providing additional insights into the respiratory status of patients during the AT.
Identifiants
pubmed: 39285376
doi: 10.1186/s12890-024-03283-4
pii: 10.1186/s12890-024-03283-4
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
454Subventions
Organisme : Bundesministerium für Gesundheit
ID : ERA PerMED 2522FSB903
Organisme : Bundesministerium für Gesundheit
ID : ERA PerMED 2522FSB903
Organisme : H2020 Marie Skłodowska-Curie Actions
ID : Rise DCPM 872488
Organisme : H2020 Marie Skłodowska-Curie Actions
ID : Rise DCPM 872488
Organisme : H2020 Marie Skłodowska-Curie Actions
ID : Rise DCPM 872488
Organisme : H2020 Marie Skłodowska-Curie Actions
ID : Rise DCPM 872488
Organisme : National Research, Development and Innovation Office
ID : OTKA K137995
Informations de copyright
© 2024. The Author(s).
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