Apnea test induced barotrauma in an obese subject with a short neck - A case report

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL BioMedicine-Taiwan Pub Date : 2023-07-20 DOI:10.51248/.v43i3.2224
S. Purushothaman, A. A. Al bshabshe, Alwadai Nasser Mohammed M., Naif Sulaiman, Omprakash Palanivel
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Abstract

Death is an assured inevitability event for all living beings of this cosmos. Based on the American Academy of Neurology (AAN) recommendations, clinical diagnosis of Brain Death (BD) includes multiple sequences of tests. The Apnea Test (AT) is a more significant procedure in diagnosing BD. Unfortunately, complications during this procedure can occur more frequently than documented, and its incidence is limited to case reports. However, most critical care physicians and Cardio-respiratory therapists consider an AT a principal method to confirm BD as it provides decisive information about the definitive loss of brainstem function. Here, we describe the execution of the AT procedure that transpired into extensive subcutaneous emphysema, tension pneumothorax, and pneumoperitoneum followed by pulseless electrical activity due to direct airway perforation by the supplemental oxygen catheter. In addition, we do a literature review on airway complications incidence and suggest methods to avoid such fatal complications. Finally, further prospective studies are recommended to evaluate the barotrauma incidence and complication nature during AT.
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呼吸暂停试验致短颈肥胖受试者气压创伤1例
死亡对于这个宇宙中的所有生物来说都是一个必然的事件。根据美国神经病学学会(AAN)的建议,脑死亡(BD)的临床诊断包括多个测试序列。呼吸暂停试验(AT)是诊断BD的一个更重要的程序。不幸的是,该程序中的并发症可能比记录的更频繁,其发生率仅限于病例报告。然而,大多数重症监护医生和心肺治疗师认为AT是确认BD的主要方法,因为它提供了有关脑干功能最终丧失的决定性信息。在这里,我们描述了AT手术的实施,该手术发展为广泛的皮下气肿、张力性肺气肿和气腹,随后由于补充氧气导管直接穿孔导致无脉冲电活动。此外,我们对气道并发症的发生率进行了文献综述,并提出了避免此类致命并发症的方法。最后,建议进行进一步的前瞻性研究,以评估AT期间气压性创伤的发生率和并发症的性质。
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来源期刊
BioMedicine-Taiwan
BioMedicine-Taiwan MEDICINE, GENERAL & INTERNAL-
CiteScore
2.80
自引率
5.90%
发文量
21
审稿时长
24 weeks
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