Pa<scp>co</scp>2 becomes greater than Pv<scp>co</scp>2 during apnoea testing for brain death diagnosis

Solsona, J. F.; Díaz, Yudith Sabina; Gracia, MP; Gener, J.; Vázquez, Aitor

doi:10.1111/j.1365-2044.2010.06261.x

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…In non-ECMO patients, PvCO 2 is higher than PaCO 2 before AT, but after AT, PaCO 2 is higher than PvCO 2 [78]. This is likely due to CO 2 production by the lungs without elimination [79]. Although this difference is not important in non-ECMO patients undergoing AT, this may be significant in ECMO patients, so blood sampling [75] Giani et al [41] Reach Target PaCO2…”

Section: Blood Gas Monitoring While On Ecmomentioning

confidence: 99%

Apnea Testing for the Determination of Brain Death: A Systematic Scoping Review

2020

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Apnea is one of the three cardinal findings in brain death (BD). Apnea testing (AT) is physiologically and practically complex. We sought to review described modifications of AT, safety and complication rates, monitoring techniques, performance of AT on extracorporeal membrane oxygenation (ECMO), and other relevant considerations regarding AT. We conducted a systematic scoping review to answer these questions by searching the literature on AT in English language available in PubMed or EMBASE since 1980. Pediatric or animal studies were excluded. A total of 87 articles matched our inclusion criteria and were qualitatively synthesized in this review. A large body of the literature on AT since its inception addresses a variety of modifications, monitoring techniques, complication rates, ways to perform AT on ECMO, and other considerations such as variability in protocols, lack of uniform awareness, and legal considerations. Only some modifications are widely used, especially methods to maintain oxygenation, and most are not standardized or endorsed by brain death guidelines. Future updates to AT protocols and strive for unification of such protocols are desirable.

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Section: Blood Gas Monitoring While On Ecmomentioning

confidence: 99%

Apnea Testing for the Determination of Brain Death: A Systematic Scoping Review

2020

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“…Thereafter, the arteriovenous carbon dioxide gradient described above becomes reversed, with arterial PCO 2 exceeding venous PCO 2 . The reversal is attributed to retention of carbon dioxide within the pulmonary circulation due to impaired gas exchange, and is compounded by the Haldane effect, wherein oxygenation of arterial blood displaces carbon dioxide from haemoglobin .…”

Section: Carbon Dioxide Clearancementioning

confidence: 99%

Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

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Apnoeic oxygenation refers to oxygenation in the absence of spontaneous respiration or mechanical ventilation. It has been described in humans for over half a century and has seen a resurgence in interest given its potential to delay oxygen desaturation during airway management, especially with the advent of high-flow nasal cannulae. This narrative review summarises our current understanding of the mechanisms of gas exchange during apnoeic oxygenation and its diverse range of clinical applications, including its use at induction of anaesthesia and for the facilitation of 'tubeless anaesthesia'. Additional discussion covers use in critical care, obese, obstetric and paediatric sub-populations. The article also highlights current research efforts aiming to enhance the evidence base for the use of this technique.

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