Challenges in Brain Death Determination and Apnea Testing for Patients with COVID-19

J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105419. doi: 10.1016/j.jstrokecerebrovasdis.2020.105419. Epub 2020 Oct 21.

Abstract

Introduction: Apnea testing remains essential for the clinical evaluation of brain death determination. In patients who test positive for SARS-CoV-2, disconnecting the patient from the ventilator and introducing high flow oxygen into the endotracheal tube increases the risk for aerosolization of airway secretions and exposure of the examiner.

Methods: Case report of a patient with an intracerebral hemorrhage that evolved to significant cerebral edema and herniation, who underwent apnea test using a method involving a t-piece and an HME filter.

Results: Patient successfully pronounced brain dead using a safe method to minimize exposure to SARS-CoV-2.

Conclusion: At a time where healthcare workers are at high risk of exposure to COVID-19, the above described method is a safe process for apnea testing in declaration of brain death.

Keywords: Apnea test; Brain death; Corona virus.

Publication types

  • Case Reports

MeSH terms

  • Apnea / diagnosis*
  • Apnea / etiology
  • Brain Death / diagnosis*
  • Brain Edema / diagnosis
  • Brain Edema / etiology*
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / transmission
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / etiology*
  • Encephalocele / diagnosis
  • Encephalocele / etiology*
  • Fatal Outcome
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Male
  • Middle Aged
  • Occupational Health*