Abstract
Background and objectives: Brain death is defined as irreversible and concomitant cessation of all cortical, subcortical and brainstem functions. This event can develop as the final outcome of different severe illnesses which are usually seen in Pediatric Intensive Care Unit (PICU).
Because of emotional, familial and financial consequences of this condition for patient's family and its impression on PICU function, it is necessary to be diagnosed in a proper time. Besides, confirmation of brain death in any patient, will result in discontinuation of all given therapeutic and supportive measures, therefore it is critically important for patient and his or her family members and physicians to be ascertained that "Brain Death" has surely happened. Apnea test is a tool to prove brain death.
Materials and Methods: Within a period of 29 months (from November 2003 toMarch2006), a Cross-Sectional study was done on 30 patients suspected to be dead by brain criteria, the apnea test was carried out for all patients in a standard manner. In each case, if arterial partial pressure of CO2 raised above 60 mmHg and no spontaneous true respiratory movements started, the test was considered to be positive and the patient's brain death confirmed.
Findings: All of 30 studied patients had positive apnea tests and died finally, although we found extensor plantar reflex in one and withdrawal reflex in extremities of 3 patients.
Results: Apnea test is the less expensive, the most rapid and practical confirmatory test for brain death with a sensitivity equal to 100% in diagnosis of this condition.
It is possible to use this test even in small hospitals where ever a mechanical ventilator and an arterial blood gas analyzer are available.