Does Venous pCO2 Increase by 20 mmHg or More During Apnea Challenge Test?
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/21/2016 |
| Start Date: | July 2015 |
| End Date: | July 2017 |
| Contact: | Dena Freeman, MPH |
| Email: | dfreeman2@memorialcare.org |
| Phone: | 562-933-1713 |
One required examination for declaration of death by neurological criteria is the apnea
challenge test. The apnea challenge test evaluates the medulla brainstem respiratory center
response to a rise in CO2. The current guideline requires arterial sampling of CO2 and
therefore either arterial puncture or arterial catheter placement for the examination.
Arterial catheter is an invasive monitoring device and is not without complications. Recent
studies have demonstrated that there is a direct correlation between peripheral venous and
arterial blood gas measures and that peripheral venous CO2 measures may be used as
alternatives to arterial CO2 measure.The purpose of this study is to evaluate brainstem
response during the apnea challenge test to a rise in venous CO2 and correlate it with the
rise in arterial measured CO2. The objective of this study is to demonstrate a similar rise
between the venous and arterial CO2 during the apnea challenge test and eliminate the
necessity of arterial blood sampling for the sole purpose of apnea challenge test in the
future.
challenge test. The apnea challenge test evaluates the medulla brainstem respiratory center
response to a rise in CO2. The current guideline requires arterial sampling of CO2 and
therefore either arterial puncture or arterial catheter placement for the examination.
Arterial catheter is an invasive monitoring device and is not without complications. Recent
studies have demonstrated that there is a direct correlation between peripheral venous and
arterial blood gas measures and that peripheral venous CO2 measures may be used as
alternatives to arterial CO2 measure.The purpose of this study is to evaluate brainstem
response during the apnea challenge test to a rise in venous CO2 and correlate it with the
rise in arterial measured CO2. The objective of this study is to demonstrate a similar rise
between the venous and arterial CO2 during the apnea challenge test and eliminate the
necessity of arterial blood sampling for the sole purpose of apnea challenge test in the
future.
Inclusion Criteria:
1. Age > 37 weeks gestation up to any adult age
2. Patients admitted to Pediatric Intensive Care unit (PICU), Neonatal Intensive Care
Unit (NICU), Medical Intensive Care Unit (MICU) and Cardiothoracic Intensive Care
Unit (CTICU)
3. Patients with irreversible brain injury where the attending physician will be
performing death by neurological criteria examination as per hospital policy
4. Presence of arterial catheter or arterial blood sampling during apnea challenge test
5. Presence of central venous catheter or easily drawing peripheral intravenous catheter
Exclusion Criteria:
1. Age less or equal to 37 weeks gestation
2. Inability to perform apnea challenge test as determined by primary physician
3. Family request for Donation after Cardiac Death (DCD) or withdrawal of Life
Sustaining Therapy
4. Bicarbonate infusion within 30 minutes of apnea challenge test
We found this trial at
1
site
Long Beach, California 90806
Principal Investigator: Alireza Fathi, MD, MBA
Phone: 562-933-1713
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