Factors other than the implementation patterns of the apnea test are closely related to ethical considerations. There were differences regarding existing laws and guidelines related to determining brain death, number of medical staff for the determination, observation duration, test for determination, and apnea test procedure. Ī survey of 80 countries showed no agreement between continents and countries, and even within one country regarding brain death diagnostic criteria and apnea test modalities for brain death. In Japan, the standard duration for the apnea test is unspecified, but the PaCO 2 is the same as in the United States. The differences between the apnea tests of the two countries mainly focus on the test duration as well as PaCO 2, which is a criterion for determining a positive apnea test. Thereafter, arterial blood gas analysis (ABGA) is performed, and the apnea test is considered positive if PaCO 2 exceeds 60 mmHg or increases by ≥20 mmHg above the reference value. In the United States, after removing the mechanical ventilator, there is observation for an apnea pattern for 8 to 10 minutes. The apnea test in the United States slightly differs from that in South Korea. If spontaneous respiration is not induced although PaCO 2 has risen to ≥50 mmHg as determined by blood gas analysis, the apnea test is deemed positive. Thereafter, the mechanical ventilator is removed, and 6 L/min of 100% O 2 is supplied through an endotracheal tube. Regarding the apnea test and positive criteria for the apnea test in South Korea, pre-oxygenation is first achieved with 100% oxygen (O 2) or 95% O 2 and 5% CO 2 via a mechanical ventilator for 10 min. Its main purpose is to demonstrate the absence of a respiration control system reflex in the brainstem when stimulation of respiration occurs with an increased partial pressure of carbon dioxide (PaCO 2). The apnea test is essential for clinically determining brain death. According to the American Academy of Neurology (AAN) guidelines, the following criteria must be met when determining brain death: presence of an irreversible etiology neurologically confirmed coma, loss of the brainstem reflex, and apnea test positivity and positive optional tests (no cerebral blood flow on angiography or transcranial Doppler ultrasound, no electrical activity on electroencephalography, and no uptake of technetium on brain scan). Although it is an established medical concept, there is no global consensus regarding the determination of brain death.
Data are available from the Institutional Review Board (IRB) of Ewha Womans University Mokdong Hospital (contact the committee by email: for researchers who meet the criteria for accessing confidential data.įunding: The author(s) received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist.īrain death was first described in 1959 and is defined as the irreversible loss of all identifiable brain functions, including those of the brainstem. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: Data cannot be shared publicly for confidentiality reasons.
Received: JanuAccepted: JPublished: July 28, 2022Ĭopyright: © 2022 Baik et al. PLoS ONE 17(7):Įditor: Steven Eric Wolf, University of Texas Medical Branch at Galveston, UNITED STATES If you are interested in from another department, please do get in touch.Citation: Baik SM, Park J, Kim TY, Hong KS (2022) Optimal duration of the apnea test for determining brain death: Benefit of the short-term apnea test. Priority is given to projects related to the Arts and Humanities. The level of licensing is will be periodically reviewed, so if you have other requirements, please do let us know.
#Oxygen xml author software
This means that the software can be used concurrently by two computers. The software has been licensed to Warwick as two floating licenses. If you believe your project could benefit from the use of the XML Author software, please contact Steve dot Ranford at warwick dot ac dot uk.
Specifically, this software is currently being used at Warwick with XSLTs, transformations applied to existing XML encoded documents for displaying in multiple formats. This software is a powerful XML authoring enviornment suited to projects that encode information in XML and related formats. The Digital Humanities team has licenced XML Author for use by research staff in the Arts and Humanities.
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