Brain Death
Conditions
Keywords
Apnea testing, Electrical Impedance Tomography
Brief summary
Apnea testing is the final decisive examination in the strictly regulated process of brain death assessment. There is no standardized method found in the literature for apnea testing except for the inspection of possible spontaneous chest movements. In addition, the test itself lasts for several minutes leading to the collapse of the lungs. Electrical impedance tomography (EIT) is a non-invasive, real-time monitoring technique, which is suitable for detecting changes in lung volumes during ventilation. With its help, one can examine the spontaneous initiation of inspiration, the development of atelectasis and the reopening of collapsed regions by mechanical ventilation. Furthermore, the apnea test provides for analysing the effect of changes in pulmonary perfusion on impedance in the absence of noise generated by ventilation.
Detailed description
The aim of the study is to assess the eligibility of electrical impedance monitoring for the detection of possible spontaneous initiations of inspiration during apnea test in patients with suspected brain death. The study could contribute to the opening of new areas in the clinical use of the electrical impedance device. An additional aim is to observe the collapse and the reopening by recruitment manoeuvers of different pulmonary regions.
Interventions
DIAGNOSTIC_TESTApnea test, alveolar recruitment
Alveolar recruitment following the phase of apnea testing
Sponsors
Budapest University of Technology and Economics
Hochschule Furtwangen University
Szeged University
Kiskunhalas Semmelweis Hospital the Teaching Hospital of the University of Szeged
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Patients with suspected brain death undergoing apnea test for detecting the absence of spontaneous breathing
Exclusion criteria
* age under 18 * pregnancy * pulmonectomy, lung resection in the past medical history * clinically end stage chronic obstructive pulmonary disease (COPD) * severe hemodynamic instability (vasopressor refractory shock) * severe bullous emphysema and/or spontaneous pneumothorax in the past medical history * chest drainage in situ due to pneumothorax and/or bronchopleural fistula
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| detection of spontaneous inspiration | 20 minutes | Detection of absolute changes in impedance using EIT during apnea test, which may refer to spontaneous initiations of inspiration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gas exchange | 20 minutes | Change in arterial partial pressure of oxygen (PaO2) (mmHg) following alveolar recruitment performed after apnea testing |
| Dynamic compliance | 20 minutes | Change in dynamic compliance (ml/cmH2O) following alveolar recruitment |
| End expiratory lung impedance | 20 minutes | Change in end expiratory lung impedance (EELI) (%) following alveolar recruitment |
| Center of ventilation | 20 minutes | Change in center of ventilation (%) following alveolar recruitment |
| Lung perfusion | 20 minutes | Changes in lung perfusion during the apnea phase (%) |
Countries
Hungary
Outcome results
None listed