Key Points ▪ Survival of the neonate depends on pulmonary vascular resistance transitioning from a high to a low state. PVR is increased by hypoxemia acidosis, hypothermia, and stress; inability to lower PVR in fetal circulation will not allow extrauterine…
Key points ▪ Patients with Huntington's disease are at higher risk of pulmonary aspiration, altered anesthetic pharmacology, and worsening generalized tonic spasms. Rapid-sequence induction with cricoid pressure is recommended for general anesthesia. ▪ Autonomic dysfunction from amyloidosis has dramatic perioperative…
Key points ▪ Airway changes throughout pregnancy worsen during labor and delivery as a result of mucosal edema. ▪ Anesthetic agents are not teratogenic; however, inhalation anesthetics and many intravenous agents may trigger developmental apoptosis and other neurologic insults that…
Key points ▪ The morbidity and mortality associated with burns vary with total area burned, depth of burn, presence of inhalation injury, and coexisting diseases. ▪ Adequate fluid resuscitation, appropriate analgesia, and early excision of wounds are vital to improve…
Key points ▪ Trauma is the 10th leading cause of death globally (16,000 people daily). Motor vehicle crashes, firearms, poisoning, falls, and suffocation account for 81% of all trauma deaths. ▪ Every anesthesiologist will likely care for injured patients acutely…
Key points ▪ With use of alternative medicines such as minerals, vitamins, and herbals increasing worldwide, the medical community needs a more comprehensive understanding of these agents. ▪ Anesthesiologists need to recognize the potential for bleeding, drug interactions, and end-organ…
Key points ▪ An estimated 26.2% of Americans age 18 and older have a diagnosable mental disorder in a given year (58 million people). ▪ Mental disorders and their associated use of psychotropic medications, including antidepressants, anxiolytics, major tranquilizers, anticonvulsants,…
Key points ▪ Oxidative phosphorylation is critical to aerobic cellular energy production. ▪ Five enzyme complexes make up the electron transport chain, encoded by nuclear DNA (nDNA) and mitochondrial DNA (mtDNA). Mutations in mtDNA or nDNA can result in defective…
Key points ▪ Anesthetic management of endocrine surgical patients should consider not only the organ of interest but also the end-organ consequences of the endocrine dysfunction and possible rare syndromes. ▪ Severe symptomatic hypercalcemia (especially > 14 mg/dL) constitutes a…
Key Points ▪ Patients with severe sepsis are at particular risk for hepatic and renal injuries. ▪ The major cardiovascular events in sepsis are vasoplegia, reduced stroke volume, and microcirculatory failure. ▪ Patients with multiorgan dysfunction syndrome (MODS) become confused,…