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Old 03-27-2012
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Medicolegal and Ethics Renal dialysis for vegatative state patient!

An elderly patient with multiple medical problems has been admitted to your care in ICU. The patient is in persistent vegetative state secondary to anoxic encephalopathy and has now developed sepsis, hypotention, GIT bleeding and respiratory failure requiring intubation. There is no improvement expected in the underlying severe brain damage. Renal failure develops to the point of needing dialysis would be completely failure

Which of the following is most appropriate step in the management?

A. hemodialysis
B. peritoneal dialysis
C. renal transplantation
D. give albumin
E. recommend that dialysis cannot be performed
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Old 03-27-2012
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Quote:
Originally Posted by usmlemydream View Post
Renal failure develops to the point of needing dialysis would be completely failure

Is that saying that the renal failure is so bad that if you start dialysis it will lead to complete failure ?

Also, I don't think the patient is brain dead, he is just in a persistent vegetative state but with extensive brain damage.

I think the answer is between C or E.
I would go with E) recommend that dialysis cannot be performed.
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Old 04-12-2012
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As far as I understand patient is in a state of multiple organ system failure.

In such case, Renal transplant (C ) can not at all be a feasible option. Because of two reasons- doubt that it could go uneventful and second the extent of marginal benefit to the patient even when it goes successful.

So I think, E is the only correct answer.
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