Indian Journal of Critical Care Case Report

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VOLUME 3 , ISSUE 3 ( May-June, 2024 ) > List of Articles

CASE REPORT

Vigilance to Prevent Organ Wastage—Bilateral Pneumothorax: A Complication of Apnea Test

Kapil G Zirpe, Sushma K Gurav, Abhijit M Deshmukh, Ramunaidu Yellapu, Anand M Tiwari, Prasad B Suryawanshi, Upendrakumar S Kapse

Keywords : Apnea test, Barotrauma, Brainstem death, Case report, Oxygen flow rate, Pneumothorax

Citation Information : Zirpe KG, Gurav SK, Deshmukh AM, Yellapu R, Tiwari AM, Suryawanshi PB, Kapse US. Vigilance to Prevent Organ Wastage—Bilateral Pneumothorax: A Complication of Apnea Test. 2024; 3 (3):78-80.

DOI: 10.5005/jp-journals-11006-0114

License: CC BY-NC 4.0

Published Online: 03-05-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

A 30-year-old male patient, known case of hypertensive, was diagnosed to have a large intracranial hemorrhage. Brainstem death was diagnosed after clinical examination. The first apnea test (AT) was positive for brain death. While performing second apnea test, 5 minutes after disconnection of ventilator, saturation dropped to 78%.........heart rate......blood pressure dropped to 70 mmHg. The AT was abandoned. Chest auscultation revealed diminished breath sounds on the left>right side. Bilateral pneumothorax was confirmed with bedside point-of-care ultrasound (POCUS). The patient's saturation improved after the insertion of the bilateral intercostal drain. The second AT was done after patient stabilization. Organ retrieval was done successfully. Tension pneumothorax is an uncommon complication during AT. The ratio internal cannulae diameter of insufflation catheter to endotracheal tube (ETT) internal diameter (ID) should be <0.6–0.7 to avoid inadvertent dynamic hyperinflation or barotrauma. The oxygen flow rate should be 6–8 L/minute.


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