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Article |

Risk of Hypotension During Apnea Testing

Joseph S. Jeret, MD; Jeffrey L. Benjamin, MD
Arch Neurol. 1994;51(6):595-599. doi:10.1001/archneur.1994.00540180073016.
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Objective:  To determine the safety of apnea testing.

Design:  Prospective, consecutive study.

Setting:  Inner-city trauma center.

Patients:  A total of 70 apnea tests were performed on 61 comatose patients as part of the determination of brain death.

Results:  Only 43 examinations (61%) were well tolerated. During 27 examinations (39%) patients either developed marked hypotension (≥ 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), seven were successfully completed after increases in the rate of dopamine infusion during the test.

Conclusions:  Hypotension 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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