[Barotrama during apnea testing for the determination of brain death]

We describe three cases of tension pneumothorax occurring during apnea testing for the determination of brain death. Every case needed needle thoracostomy for emergency chest deflation and/or a chest tube to be inserted rapidly. Moreover, haemodynamic and oxygenation parameters were impaired in each of the patients after these pneumothorax. This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the third patient and consequently loosing the pulmonary graft. Limitation of oxygen insufflation up to 8 L.min-1 with a 12 F oxygen supply tubing inserted within 5 cm into the endotracheal tube should be recommended to avoid this iatrogenic complication.