One life ends, another begins: Management of a brain-dead pregnant mother - A systematic review -

Background: An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy. Methods: To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome. Results: In our search of the literature, we found 30 cases reported between1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period. Conclusion: The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor

Constant volume combustion of dust suspensions in microgravity

In this thesis, constant volume combustion of dust mixtures of varying particle size was investigated. A reduced gravity environment assisted in the generation of a quiescent, uniform dust suspension of known concentration, by allowing time for the decay of dispersion turbulence in the absence of gravity sedimentation. The difference between the theoretical and experimental maximum explosion pressures was systematically studied. Heat loss mechanisms, conduction and radiation, were evaluated in order to determine their contribution to the experimental pressure deficit. Gaseous explosions were also studied to validate the method of analysis and to provide a basis for comparison. It was found that conduction plays a negligible role in reducing the maximum explosion pressure in both gaseous and dust combustion until the flame is within one flame thickness from the vessel wall, causing flame quenching. The most significant factor in reducing the maximum explosion pressure was found to be flame quenching by the chamber wall in both the dust and gas flames, however radiative heat loss was found to contribute up to 10% of the experimental pressure deficit in the highly luminous aluminum dust flames

Directed Organ Donation After Euthanasia.

Organ donation after euthanasia is performed in Belgium, the Netherlands, Canada and Spain. Directed deceased organ donation is currently possible under strict conditions in a limited number of countries, while it is currently not possible to opt for directed donation following euthanasia. While organ donation after euthanasia is a deceased donation procedure, directed organ donation after euthanasia could be seen as a deceased donation procedure with a living donation consent process. Therefore, directed organ donation after euthanasia is feasible on medical and ethical grounds. Strict safeguards should be in place, including the requirement of a pre-existing familial or personal relationship with the proposed recipient, without any evidence of coercion or financial gain