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PULMONARY STRAIN AND END-EXPIRATORY LUNG VOLUME DURING APNEA TEST: A COMPARATIVE ANALYSIS USING ELECTRICAL IMPEDANCE TOMOGRAPHY.

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Title: PULMONARY STRAIN AND END-EXPIRATORY LUNG VOLUME DURING APNEA TEST: A COMPARATIVE ANALYSIS USING ELECTRICAL IMPEDANCE TOMOGRAPHY.
Alternate Title: Stress pulmonar y volumen pulmonar de fin de espiración durante el test de apnea: Estudio comparativo utilizando tomografía por impedancia eléctrica.
Authors: Fernández Ceballos, Ignacio1 (AUTHOR) ignacio.fernandez@hospitalitaliano.org.ar, Ems, Joaquín1 (AUTHOR), Steinberg, Emilio1 (AUTHOR), Nuñez Silveira, Juan M1 (AUTHOR), Hornos, Micaela B.1 (AUTHOR), Berdiñas Anfuso, Melany1 (AUTHOR), Videla, Carlos1 (AUTHOR), Ciarrocchi, Nicolás M.1 (AUTHOR), Carboni Bisso, Indalecio1 (AUTHOR), Las Heras, Marcos1 (AUTHOR)
Source: Medicina (Buenos Aires). mar/abr2024, Vol. 84 Issue 2, p359-363. 5p.
Subjects: ELECTRICAL impedance tomography, BRAIN death, LUNG injuries, HYPERCAPNIA, HYPOXEMIA
Abstract (English): The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the patient from invasive mechanical ventilation (iMV) for approximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2. Common complications include hypoxemia and hemodynamic instability, and lung collapse-induced reduction in end-expiratory lung volume (EELV). In our case series utilizing electrical impedance tomography (EIT), we observed that continuous positive airway pressure during the apnea test (CPAP-AT) effectively mitigated lung collapse. This resulted in improved pulmonary strain compared to the disconnection of iMV. These findings suggest the potential benefits of routine CPAP-AT, particularly for potential lung donors, emphasizing the relevance of our study in providing quantitative insights into EELV loss and its association with pulmonary strain and potential lung injury. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): La prueba de apnea es una técnica diagnóstica ampliamente utilizada para la evaluación de la muerte cerebral, con el objetivo de demostrar la ausencia de impulso respiratorio debido a la hipercapnia. La variante de la prueba de apnea con insuflación de oxígeno traqueal (I-AT) implica desconectar al paciente de la ventilación mecánica invasiva (iVM) durante aproximadamente 8 minutos, manteniendo la oxigenación mediante un catéter de insuflación. Esta prueba respalda el diagnóstico de muerte cerebral cuando se determina un aumento de la PaCO2 superior a 20 mmHg en comparación con el valor inicial o un nivel de PaCO2 superior a 60 mmHg al final de la prueba. En nuestra serie de casos, la implementación de la tomografía de impedancia eléctrica (EIT) reveló que la prueba de apnea con presión positiva continua (CPAPAT) mitiga eficazmente el colapso pulmonar. Este enfoque resulta en una mejora en la tensión pulmonar en comparación con la desconexión de iMV, demostrando su relevancia en el contexto de potenciales donantes de pulmones. [ABSTRACT FROM AUTHOR]
Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: PULMONARY STRAIN AND END-EXPIRATORY LUNG VOLUME DURING APNEA TEST: A COMPARATIVE ANALYSIS USING ELECTRICAL IMPEDANCE TOMOGRAPHY.
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  Data: Stress pulmonar y volumen pulmonar de fin de espiración durante el test de apnea: Estudio comparativo utilizando tomografía por impedancia eléctrica.
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  Data: <searchLink fieldCode="JN" term="%22Medicina+%28Buenos+Aires%29%22">Medicina (Buenos Aires)</searchLink>. mar/abr2024, Vol. 84 Issue 2, p359-363. 5p.
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  Data: <searchLink fieldCode="DE" term="%22ELECTRICAL+impedance+tomography%22">ELECTRICAL impedance tomography</searchLink><br /><searchLink fieldCode="DE" term="%22BRAIN+death%22">BRAIN death</searchLink><br /><searchLink fieldCode="DE" term="%22LUNG+injuries%22">LUNG injuries</searchLink><br /><searchLink fieldCode="DE" term="%22HYPERCAPNIA%22">HYPERCAPNIA</searchLink><br /><searchLink fieldCode="DE" term="%22HYPOXEMIA%22">HYPOXEMIA</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the patient from invasive mechanical ventilation (iMV) for approximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2. Common complications include hypoxemia and hemodynamic instability, and lung collapse-induced reduction in end-expiratory lung volume (EELV). In our case series utilizing electrical impedance tomography (EIT), we observed that continuous positive airway pressure during the apnea test (CPAP-AT) effectively mitigated lung collapse. This resulted in improved pulmonary strain compared to the disconnection of iMV. These findings suggest the potential benefits of routine CPAP-AT, particularly for potential lung donors, emphasizing the relevance of our study in providing quantitative insights into EELV loss and its association with pulmonary strain and potential lung injury. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: La prueba de apnea es una técnica diagnóstica ampliamente utilizada para la evaluación de la muerte cerebral, con el objetivo de demostrar la ausencia de impulso respiratorio debido a la hipercapnia. La variante de la prueba de apnea con insuflación de oxígeno traqueal (I-AT) implica desconectar al paciente de la ventilación mecánica invasiva (iVM) durante aproximadamente 8 minutos, manteniendo la oxigenación mediante un catéter de insuflación. Esta prueba respalda el diagnóstico de muerte cerebral cuando se determina un aumento de la PaCO2 superior a 20 mmHg en comparación con el valor inicial o un nivel de PaCO2 superior a 60 mmHg al final de la prueba. En nuestra serie de casos, la implementación de la tomografía de impedancia eléctrica (EIT) reveló que la prueba de apnea con presión positiva continua (CPAPAT) mitiga eficazmente el colapso pulmonar. Este enfoque resulta en una mejora en la tensión pulmonar en comparación con la desconexión de iMV, demostrando su relevancia en el contexto de potenciales donantes de pulmones. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Text: English
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      – SubjectFull: ELECTRICAL impedance tomography
        Type: general
      – SubjectFull: BRAIN death
        Type: general
      – SubjectFull: LUNG injuries
        Type: general
      – SubjectFull: HYPERCAPNIA
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      – SubjectFull: HYPOXEMIA
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      – TitleFull: PULMONARY STRAIN AND END-EXPIRATORY LUNG VOLUME DURING APNEA TEST: A COMPARATIVE ANALYSIS USING ELECTRICAL IMPEDANCE TOMOGRAPHY.
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