吉林省脑死亡判定自主呼吸激发试验的实施率和完成率分析

目的通过分析脑死亡判定自主呼吸激发试验（AT）的质控指标，探讨改进策略，提高AT的实施率和完成率。方法收集吉林省脑损伤质控中心2017年-2020年脑死亡判定病例相关资料，依据标准进行AT技术质控，分析AT实施率和完成率情况。结果AT实施率由2017年的4.3%提升至2020年的83.5%；完成率由2017年的66.7%提升至2020年的96.1%。实施AT后可出现严重酸中毒、低血压、低血氧、低血钾等风险，未实施AT和未完成AT的原因主要为血压、心率、血氧不稳定。结论通过医师间、医护间的技术合作，有利于提升实施AT的安全性。为进一步提升AT实施率和完成率，建议制定出现AT相关心跳骤停情况的不苛责机制，健全AT相关培训及考核制度。

Analysis of Implementation Rate and Completion Rate of Apnea Test in Brain Death Determination in Jilin Province

ObjectiveTo improve the implementation rate and completion rate of Apnea Test (AT) by analyzing the quality control indicators of AT of brain death determination and discuss improvement strategy.MethodsThe relevant data of brain death determination cases from 2017 to 2020 in Brain Injury Quality Control Center of Jilin Province were collected, and AT technical quality control was conducted according to the standards, and the implementation rate and completion rate of AT were analyzed. ResultsThe implementation rate increased from 4.3% in 2017 to 83.5% in 2020, and the completion rate increased from 66.7% in 2017 to 96.1% in 2020. Severe acidosis, hypotension, hypoxemia,hypokalemia and other risks may occur after the implementation of AT. The main reasons for not implementing or completing AT were unstable blood pressure, heart rate and blood oxygen.Conclusion Technical cooperation between medical staff was beneficial to improve the safety of AT implementation. In order to further improve the implementation rate and completion rate of AT, it was suggested to establish a non-strict mechanism for the occurrence of AT-related cardiac arrest, and improve the training and assessment system of AT.