ABSTRACT
Brain-dead potential donors manifest devastating physiological changes associated with pulmonary edema, profound hemodynamic and metabolic abnormalities. These derangements may be more significant after apnea tests which result in severe hypoxemia and cardiovascular complications. De-recruitment can occur following apnea tests in the brain-dead donor whose ventilator support has been maintained with high positive end-expiratory pressure (PEEP), and recruitment maneuvers are intended to open collapsed lung units. We report a brain-dead potential donor with severe hypoxemia and hemodynamic instability after apnea tests, which improved after multiple alveolar recruitments with adequate vasoactive drugs. Multiple high-pressure recruitment maneuvers will be helpful for expansion of lung collapse with improvement of severe hypoxemia after de-recruitment which could be developed with apnea tests in brain-dead organ donor.