Risk of hypotension during apnea testing

Arch Neurol. 1994 Jun;51(6):595-9. doi: 10.1001/archneur.1994.00540180073016.

Abstract

Objective: To determine the safety of apnea testing.

Design: Prospective, consecutive study.

Setting: Inner-city trauma center.

Patients: A total of 70 apnea tests were performed on 61 comatose patients as part of the determination of brain death.

Results: Only 43 examinations (61%) were well tolerated. During 27 examinations (39%) patients either developed marked hypotension (> or = 15% drop in mean arterial pressure) (n = 23) or required prophylactic vasopressor manipulation (n = 4). Of the 27 examinations in which hypotension developed, 14 were aborted, two were tolerated despite marked hypotension, four were tolerated after administration of prophylactic epinephrine (n = 1) or dopamine hydrochloride (n = 3), and seven were successfully completed after increases in the rate of dopamine infusion during the test.

Conclusions: Hypotension can pose a significant risk to patients undergoing apnea testing. Constant monitoring of vital signs throughout the test is essential to its safe completion.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apnea*
  • Brain Death / diagnosis
  • Female
  • Humans
  • Hypotension / etiology*
  • Methods
  • Middle Aged
  • Monitoring, Physiologic
  • Oxygen / therapeutic use*
  • Prospective Studies

Substances

  • Oxygen