Cardiac Oscillations Complicating Brain Death Diagnosis

Author:

Bolt Brittany1,Muakkassa Farid2,Bruening Lindsay3,Marcus Cameron4,Cunningham Brittany5ORCID,Pawlak Erin3,Gandee Richard13,Newey Christopher16ORCID

Affiliation:

1. Cerebrovascular Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA

2. Section of Trauma, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA

3. Section of Neurology, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA

4. Section of Emergency Medicine, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA

5. Section of Pharmacy, Cleveland Clinic Akron General Hospital, Akron, Ohio, USA

6. Department of Neurocritical Care and ICU-EEG, Sanford Health, Sioux Falls, OH, USA

Abstract

Death by neurologic criteria (DNC) or brain death is a clinical diagnosis. It is often complicated by variations in policies as well as confounders on examination. We discuss here the case of a 27-year-old male who had a cardiac arrest following toxic gaseous exposure. He ultimately progressed to brain death but was identified as having cardiac oscillations during clinical assessments that complicated the diagnosis. We discuss the case as well as the maneuvers used to clarify that the “triggered breaths” on the ventilator were indeed cardiac oscillations.

Publisher

Hindawi Limited

Subject

Critical Care and Intensive Care Medicine

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