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Chapter 16 - Brain death and somatic support

from Section 2 - General medical considerations

Published online by Cambridge University Press:  05 July 2013

Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

Brainstem death in the pregnant patient is a tragic but fortunately rare event that involves complex medical, ethical, and legal issues. Prolongation of maternal somatic function constitutes experimental care where the physician must consult case reports and reviews and extrapolate from experiences in sustaining organ function after brain death to facilitate organ donation. Nutritional support should be initiated early and preferably via the enteral route. Special attention should be paid to the management of gastroesophageal reflux in the context of pregnancy and of the reduced motility of the gastrointestinal tract in brain-dead patients. Three main sources of sepsis may complicate prolonged somatic support, including ventilator associated pneumonia, urinary tract infections from dwelling catheters, and infection of intravascular catheters. The goal of extended maternal somatic support is to attempt to facilitate fetal maturation in order to deliver a healthy, viable infant.
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Chapter
Information
Maternal Critical Care
A Multidisciplinary Approach
, pp. 174 - 178
Publisher: Cambridge University Press
Print publication year: 2013

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