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Tension pneumothorax complicating apnea testing during brain death evaluation
Joseph D Burns1, James A Russell
1Department of Neurology, Lahey Clinic Medical Center, Burlington, MA 01805, USA. joseph.burns@lahey.org
Summary
Tension pneumothorax is a rare complication during apnea tests. Direct airway perforation by oxygen cannulas can cause this serious condition, necessitating preventative measures.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Anesthesiology
Background:
- The apnea test with apneic oxygenation is used to assess respiratory function.
- Complications like air trapping have been reported with this method.
Observation:
- A case of tension pneumothorax, pneumomediastinum, and pneumoperitoneum occurred during an apnea test.
- The complication was directly caused by the supplemental oxygen cannula perforating the airway.
Findings:
- This case highlights direct airway perforation as a cause of severe complications during apnea testing.
- Massive air trapping is a previously recognized, but distinct, mechanism.
Implications:
- Clinicians should be aware of the risk of direct airway injury from oxygen cannulas during apnea tests.
- Reviewing and refining techniques for supplemental oxygen delivery during apnea tests is crucial to prevent catastrophic airway complications.
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Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Clinical Manifestations:
Clinical Manifestations:
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