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Войти в исследования Anaesthesia, critical care & pain medicine · 2026
High-flow oxygen for apnea testing in brain death determination.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Legros Vincent, Chabot Paul, Gelisse Elodie, Bouvet Jeanne, Seube-Remy Pierre-Antoine
Аннотация
BACKGROUND: Apnea testing is mandatory for brain death determination but may induce hypoxemia despite standard preoxygenation procedures. High-flow oxygen (HFO) systems may improve apneic oxygenation during the procedure, although clinical data remain limited.
METHODS: We conducted a retrospective single-center cohort study including consecutive adult patients undergoing apnea testing for brain death determination between January 2023 and May 2026. Standard oxygen insufflation (6-15 L/min) was compared with HFO delivered through the Opt970® interface (Fisher & Paykel) at 50 L/min and FiO2 1.0. The primary outcome was longitudinal pulse oximetry saturation (SpO2) evolution during apnea testing. Secondary outcomes included desaturation events and arterial blood gas parameters. Repeated SpO2 measurements were analyzed using a linear mixed-effects model.
RESULTS: A total of 144 apnea tests were analyzed, including 78 using standard oxygen insufflation and 66 using HFO. Baseline characteristics and ventilatory parameters were comparable between groups. Lowest SpO2 during apnea testing was significantly higher with HFO (100 [98-100] vs. 99 [95-99]; p = 0.003), while desaturation below 94% occurred less frequently (9.1% vs. 21.8%; p = 0.04). Post-test PaCO2 was slightly higher in the HFO group (73 [67-81] vs. 70 [62-77] mmHg; p = 0.04). Longitudinal mixed-effects analysis demonstrated a significant decrease in SpO2 over time in both groups (p < 0.0001). However, HFO was associated with overall higher SpO2 values throughout the procedure (β=+1.38; standard error 0.69; p = 0.047), without significant group-by-time interaction (p = 0.578).
CONCLUSION: HFO delivered through the Opt970® device was associated with modestly higher oxygen saturation during apnea testing compared with standard oxygen insufflation. Further prospective studies are required to confirm these findings.
METHODS: We conducted a retrospective single-center cohort study including consecutive adult patients undergoing apnea testing for brain death determination between January 2023 and May 2026. Standard oxygen insufflation (6-15 L/min) was compared with HFO delivered through the Opt970® interface (Fisher & Paykel) at 50 L/min and FiO2 1.0. The primary outcome was longitudinal pulse oximetry saturation (SpO2) evolution during apnea testing. Secondary outcomes included desaturation events and arterial blood gas parameters. Repeated SpO2 measurements were analyzed using a linear mixed-effects model.
RESULTS: A total of 144 apnea tests were analyzed, including 78 using standard oxygen insufflation and 66 using HFO. Baseline characteristics and ventilatory parameters were comparable between groups. Lowest SpO2 during apnea testing was significantly higher with HFO (100 [98-100] vs. 99 [95-99]; p = 0.003), while desaturation below 94% occurred less frequently (9.1% vs. 21.8%; p = 0.04). Post-test PaCO2 was slightly higher in the HFO group (73 [67-81] vs. 70 [62-77] mmHg; p = 0.04). Longitudinal mixed-effects analysis demonstrated a significant decrease in SpO2 over time in both groups (p < 0.0001). However, HFO was associated with overall higher SpO2 values throughout the procedure (β=+1.38; standard error 0.69; p = 0.047), without significant group-by-time interaction (p = 0.578).
CONCLUSION: HFO delivered through the Opt970® device was associated with modestly higher oxygen saturation during apnea testing compared with standard oxygen insufflation. Further prospective studies are required to confirm these findings.