Feasibility of performing apnea test in a brain dead patient on veno-venous extracorporeal membrane oxygenation (ECMO)
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Extracorporeal membrane oxygenation (ECMO) is being increasingly used to provide support in patients with refractory cardiopulmonary distress syndromes. Neurological sequelae, either from the ECMO or the hypoxic/hypotensive event leading to ECMO, are common. We present a patient requiring veno-venous (V-V) ECMO for an acute respiratory distress syndrome (ARDS) following cardiopulmonary arrest who suffered an irreversible brain injury. Eventually she required an evaluation for death by neurological criteria while on V-V ECMO making apnea testing challenging. We report the ability to safely perform apnea testing in a patient with a devastating brain injury requiring V-V ECMO.
Am J Hosp Med 2017 Jul;1(3):2017.022 https://doi.org/10.24150/ajhm/2017.022