Atropine test for Brain Death Determination

Q: The atropine test is considered positive for brain death determination if the heart rate response to intravenous injection of 2-3 mg atropine shows 

A) an increase in heart rate less than 3 percent
B) an increase in heart rate less than 10 percent
C) a decrease in heart rate more than 3 percent
D) a decrease in heart rate more than 10 percent
E) Patient develops ventricular tachycardia



Answer: A


The atropine test assesses bulbar parasympathetic activity on heart activity in brain-dead patients. 2-3 mg of atropine is injected under continuous monitoring of the EKG over 10 minutes. The test is considered negative if heart rate is not increased by more than 3%.


References:

1. Siemens P, Hilger HH, Frowein RA. Heart rate variability and the reaction of heart rate to atropine in brain dead patients. Neurosurg Rev 1989; 12 Suppl 1:282.

2. Huttemann E, Schelenz C, Sakka SG, et al. Atropine test and circulatory arrest in the fossa posterior assessed by transcranial Doppler. Intensive Care Med. 2000;26:422–5.

3. Cardan C, Roth A, Biro J. The atropine test in the assessment of brain death. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1983;32:393–7