Background: The fourth edition of the German guideline for the assessment of brain death, published in 2015 by the German Medical Council (Bundesärztekammer), emphasizes the importance of an apnea test. It is also now required under all circumstances of extracorporeal life support.
Objectives: This article is an instruction for the guideline-conforming performance of an apnea test in general and also in cases of extracorporeal life support in different configurations.
Materials and methods: A literature review was performed.
Conclusions: The apnea test is an essential part of the bedside examination for the clinical diagnosis of brain death. It is required for all kinds of extracorporeal life support and can be easily performed without endangering the patient. More accurate recommendations for its performance should be considered for the next version of the German guideline for brain death assessment.
Keywords: Apnea test; Brain death; Cessation of brain function; ECMO; Extracorporeal life support.