Document Detail

Efficacy of a T-piece system and a continuous positive airway pressure system for apnea testing in the diagnosis of brain death.
MedLine Citation:
PMID:  16540953     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To prospectively compare three methods of apnea testing for the confirmation of brain death. DESIGN: Prospective, randomized, crossover study. SETTING: Intensive care unit of a tertiary care university hospital. PATIENTS: Twenty adult patients requiring apnea testing for confirmation of brain death. INTERVENTIONS: Ten minute apnea testing was repeated in random order for every patient with the three oxygenation systems: oxygen catheter inserted through the endotracheal tube (oxygen 6 L/min), T-piece system (oxygen 12 L/min), and continuous positive airway pressure (CPAP) system 10 cm H2O (oxygen 12 L/min). MEASUREMENTS AND MAIN RESULTS: Arterial blood was drawn at 0, 2, 5, and 10 mins of each test. Compared with baseline, Paco2 increased by 30.6 +/- 7.4, 30.0 +/- 7.3 and 30.2 +/- 7.5 mm Hg during the apnea period (p = .96), reaching 73.3 +/- 8.3, 71.6 +/- 11.1, and 72.7 +/- 9.0 mm Hg at the end of the apnea test (p = .73) for the oxygen catheter, the T-piece, and the CPAP, respectively. Pao2 decreased less with the CPAP compared with the oxygen catheter or the T-piece (-22.4 +/- 76, -99.1 +/- 158, and -91.6 +/- 133 mm Hg, respectively, p < .01). In two patients, apnea testing could not be completed with the oxygen catheter and the T-piece because of desaturation, although it could be completed with the CPAP. CONCLUSIONS: The T-piece and the CPAP systems are effective alternatives to the standard oxygen catheter technique for apnea testing. Oxygenation was best maintained with the CPAP system, which can be useful in some patients.
Simon Lévesque; Martin R Lessard; Pierre C Nicole; Stéphan Langevin; François LeBlanc; François Lauzier; Jacques G Brochu
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Critical care medicine     Volume:  34     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2006-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2213-6     Citation Subset:  AIM; IM    
Department of Anesthesiology, Centre Hospitalier Affilié Universitaire de Québec, Université Laval, Quebec City, Quebec, Canada.
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MeSH Terms
Apnea / blood*
Brain Death / diagnosis*
Carbon Dioxide / blood
Catheters, Indwelling
Continuous Positive Airway Pressure*
Cross-Over Studies
Hospitals, University
Intensive Care Units
Intubation, Intratracheal
Middle Aged
Oxygen / blood
Oxygen Inhalation Therapy / methods
Prospective Studies
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comment In:
Crit Care Med. 2006 Aug;34(8):2257   [PMID:  16883203 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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