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J Pediatr Intensive Care 2019; 08(02): 108-112
DOI: 10.1055/s-0038-1675193
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Apnea Threshold in Pediatric Brain Death: A Case with Variable Results Across Serial Examinations

Tina Sosa
1   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
,
Zachary Berrens
2   Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
Susan Conway
2   Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
,
Erika L. Stalets
2   Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
› Author Affiliations Funding None.
Further Information

Publication History

20 May 2018

08 September 2018

Publication Date:
06 November 2018 (online)

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Abstract

Consensus guidelines currently exist for the evaluation of pediatric patients with suspected brain death. The guidelines include the requirement for two consistent examinations separated by an observation period and a threshold of 60 mm Hg for PaCO2 during apnea testing. We present a patient who met all prerequisites to perform brain death examination but had variability in examinations during apnea testing. We discuss our strategy in managing these unexpected findings, including the importance of open and ongoing communication with the family, and the implications for current guidelines for the determination of brain death in pediatric patients.

Keywords

Pediatric - brain death - apnea
 

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