| Autor: |
Fernández Ceballos I; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. E-mail: ignacio.fernandez@hospitalitaliano.org.ar., Ems J; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Steinberg E; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Nuñez Silveira JM; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Hornos MB; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Berdiñas Anfuso M; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Videla C; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Ciarrocchi NM; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Carboni Bisso I; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Las Heras M; Unidad de Cuidados Intensivos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. |
| Abstrakt: |
The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the patient from invasive mechanical ventilation (iMV) for approximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2. Common complications include hypoxemia and hemodynamic instability, and lung collapse-induced reduction in end-expiratory lung volume (EELV). In our case series utilizing electrical impedance tomography (EIT), we observed that continuous positive airway pressure during the apnea test (CPAP-AT) effectively mitigated lung collapse. This resulted in improved pulmonary strain compared to the disconnection of iMV. These findings suggest the potential benefits of routine CPAP-AT, particularly for potential lung donors, emphasizing the relevance of our study in providing quantitative insights into EELV loss and its association with pulmonary strain and potential lung injury. |
