| Co-Investigator(Kenkyū-buntansha) |
SASAKI Akira Tottori University Hospital, ICU, Assistant, 医学部・附属病院, 助手 (60243391)
TSUDA Kazuo Tottori University Hospital, ICU, Ass5stant, 医学部・附属病院, 助手 (00163808)
SAITO Noriki Tottori University Hospital, ICU, Lecturer, 医学部・附属病院, 講師 (40116330)
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| Budget Amount *help |
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1993: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1992: ¥1,100,000 (Direct Cost: ¥1,100,000)
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| Research Abstract |
Two kinds of apnea tests (I and A methods) wethods) were compared on each of 16 brain-death patients admitted in ICU and HCU of Tottori University Hospital from May 92 to December 1993. The first method is that used in the diagnostic criteria for brain death proposed by Dr. Takeuchi group of koseisho (Ministry of Health), where the apnea test is defined to be performed with 6 l/min oxygen insufflation thrugh a catheter inserted into the trachea tube toward the patient's carina for 10 minutes after disconnection from the ventilator (I method). In the second test, we proposed, apneic oxygenation technique (Frumin 1959) was spplied instead of insufflation (A method). More than 6 hrs after I method, A method was prefomed in early 9 cases by March 31, 1993, and the order of the apnea test was reversed in the rest 7 cases. Throughout the apnea test arterial blood gas was analyzed and vital signs were measured at 6 stages ; prior to the test (Pre), 1, 3, 5, 7 and 10 min after the initiation o
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f the test. Data on all the 16 cases by I and A methods respectively were collected and statistically analyzed between the stages and the two methods. No spontaneous breathing was observed at all in any caseduring the anea tests. PaCO_2, which was 49(〕SY.+-.〔)8 torr (mean(〕SY.+-.〔)SD) in I and 47(〕SY.+-.〔)6 in A, respectively at Pre increased significantly at 3 min stage and up to 89(〕SY.+-.〔)17 in both at 10 mn stage. PaO_2, which was 378(〕SY.+-.〔)143 torr in I and 336(〕SY.+-.〔)159 in A at Pre, decreased significantly after 1 min and 3 min and finally down to 290(〕SY.+-.〔)168 and 252(〕SY.+-.〔)132, respectively. Blood pH, which was 7.33(〕SY.+-.〔)0.06 in I and 7.33(〕SY.+-.〔)0.09 in A, decreased significantly during the test, finally to 7.12(〕SY.+-.〔)0.08 and 7.10(〕SY.+-.〔)0.09 at 10 min stage, respectively. Systolic BP decreased significantly at 10 min stage in A.Diastolic BP decreased significantly at 10 min in I, and at 7 and 10 min stages in A.HR showed no significant
Between I and A methods, no significant differences of all parameters were observed in any stage durng the test. Therefore, alterative use of A instead of I method should result in no change upon a final judgment of brain-death, but A method shall be apneic in more strict sense because I method can not elminate varying artifital ventilatory factors of the insufflaton techinque. Less
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