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Apnea testing is a standard method when diagnosing brain or more specifically brainstem death; however, it is imperative to acknowledge the potential for lung injury during this procedure and follow clinical practice guideline recommendations that may reduce the risk of complications. Two cases of barotrauma leading to pneumothorax occurred during apnea tests that used higher-than-recommended oxygen flow rates. Additional data are necessary to clarify the mechanism and incidence of this life-threatening complication.