Apnea Documentation for Determination of Brain Death in Children

Abstract

Discontinuing ventilatory support for determination of respiratory drive is a recognized means of assessing clinical brain death. Methodology must include a means for assuring adequate oxygenation during the test as well as providing sufficient duration for appropriate hypercarbia. Nine patients with other findings of clinical brain death were prospectively assessed with a standardized apnea test protocol. None demonstrated spontaneous respiration. Whereas adequate oxygenation was maintained in each case, wide variability was evident in degree of hypercarbia and acidosis.