• J S Jeret and J L Benjamin.
• Department of Neurology, State University of New York Health Science Center at Brooklyn.
• Arch Neurol Chicago. 1994 Jun 1;51(6):595-9.

ObjectiveTo determine the safety of apnea testing.DesignProspective, consecutive study.SettingInner-city trauma center.PatientsA total of 70 apnea tests were performed on 61 comatose patients as part of the determination of brain death.ResultsOnly 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.ConclusionsHypotension can pose a significant risk to patients undergoing apnea testing. Constant monitoring of vital signs throughout the test is essential to its safe completion.

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