Apparent ventilator triggering in a brainstem dead patient

Abstract

Ventilator auto-triggering is a potential confounding factor in brainstem death with implications in delaying brainstem death testing. We report a case of a brainstem dead patient with extensive intracranial haemorrhage, tonsillar herniation and an absence of intracranial perfusion. Prior to brainstem death testing, there was apparent triggering of the ventilator mimicking spontaneous respiratory efforts which raised the possibility of residual brain activity. Further analysis revealed ventilator auto-triggering as the cause and the patient was certified brainstem dead.