Jahi McMath (13) died for real five years after she was declared brain dead following surgery complications

[morbidT]

Vasopressin in this setting would be used to treat DI (diabetes insipidus) which causes the kidneys to lose their ability to concentrate urine. This results in very large amounts of very dilute urine being excreted (specific gravity close to water) which if untreated causes dehydration and high sodium levels. DI is common in head injured patients.

Vasopressin is not used routinely to support blood pressure. It is used in code situations and hypotension related to septic shock. If she needed a drip to maintain BP I would expect to see her on dopamine or phenylephrine. The fact that her only med is vasopressin actually tells me that she is hemodynamically stable.

*credentials available on request.

I'm not going to dispute the treatment for DI or that it is uncommon in head injured patients. I'm aware of it as many of the organ donors I have managed suffered TBI's (traumatic brain injury).

Vasopressin may be a preferred method of therapy in people who are being resuscitated but Jahi is not. She's being maintained, so in this situation, vasopressin is very much appropriate. Adding dopamine will dilate the vascular structure and cause her to be hypotensive, which she probably already is, and why the vasopressin is being used.

Vasopressin and dopamine therapies are very tricky to balance with a dead person. She also isn't having routine labs performed to know the pH balance, electrolyte balance, or even organ function. The hospital was court ordered to maintain blood pressure so they are doing that by observing vitals and without the knowledge of what her organ function is.



Maintaining a dead body is vastly different from maintaining a live person. Even with credentials. It's a completely different world.

Sorry to disappoint, I have no interest in your credentials. I have my own.


ETA: That statement is also something said by nurses to professionals in pre-hospital medicine.

Until nurses become professionals in pre-hospital medicine.