Batrotrauma during apnea testing for the determination of brain death.

We describe three cases of tension pneumothorax occurring during apnea test ing for the determination of brain death. Every case needed needle thoracos tomy for emergency chest deflation and/or a chest tube to be inserted rapid ly. Moreover, haemodynamic and oxygenation parameters were impaired in each of the patients after these pneumothorax. This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the t hird patient and consequently loosing the pulmonary graft. Limitation of ox ygen insufflation up to 8 L . min(-1) with a 12 F oxygen supply tubing inse rted within 5 cm into the endotracheal tube should be recommended to avoid this iatrogenic complication. (C) 2001 Editions scientifiques et medicates Elsevier SAS.