Acknowledgment The author would like to acknowledge Drs. Mehmet Ozcan and James Feld’s contributions to this chapter in the previous edition. Risk 12% of all hospitalized pts as well as 44–60% of all pts admitted to medical/surgical and pediatric ICUs,…
Risk Defined as plasma K + <3.5 mEq Common conditions and/or treatments place pts at increased risk, including Those on diuretics (especially loop and thiazide diuretics) to treat Htn, CHF, and so forth. Those experiencing significant GI fluid loss (e.g.,…
Risk Prolonged propofol infusion due to lipid vehicle Genetic defects in triglyceride metabolism Component of the metabolic syndrome (obesity, hypertriglyceridemia, low HDL, Htn, diabetes) Perioperative Risks Associated with atherosclerosis, coronary, and cerebrovascular disease. Hyperglycemia (metabolic syndrome) increases risk of surgical…
Risk Incidence in USA: 300,000-500,000 individuals/y develop hyperthyroidism. In addition, 7.5% of pregnant women become hyperthyroid (highest prevalence in second trimester). 1:1000 females; 1:3000 males. Race with highest prevalence: Unknown. Perioperative Risks Risk related to occurrence of thyroid storm; increased…
Risk 1.5 billion worldwide in 2014 70 million people in USA; approximately 1:3 people USA highest prevalence: African American Male = female Perioperative Risks Increased risk of MI and stroke Increased risk of CHF, ventricular hypertrophy, coronary artery disease, and…
Risk In USA about 77.9 million (1:3) adults have high BP. Incidence of Htn increases with advancing age. Half of people 60–69 y and three-quarters of people >70 y are affected. There is a continuous relationship between BP and the…
Risk Incidence in USA: 100,000 pts/y; increases with age Male:female ratio: 1:2; 0.8% in pregnancy Prevalence: 0.7% in general population; up to 3% in postmenopausal women Due to malignancy, vitamin D deficiency, sarcoidosis Perioperative Risks Hypovolemia and electrolyte disturbances Increased…
Risk Older age, infants, prior brain injury, DM, surgery, diuretic therapy, altered mental status, insufficient water intake, DI, hypertonic sodium solution (including sodium bicarbonate), hyperalimentation, hyperaldosteronism, Cushing syndrome, and hypothalamic injury Perioperative Risks Increased incidence of morbidity and mortality, seizures,…
Risk Pts with renal insufficiency, especially those receiving Mg 2+ -containing cathartics or antacids. Parturients on MgSO 4 therapy. “Runaway” infusion of Mg 2+ during transportation to the OR can cause acute, life-threatening hypermagnesemia. Risk of developing very high serum…
Risk Any pt with plasma K + concentration <5.5 mEq/L Perioperative Risks Muscle weakness and paralysis Cardiac conduction system abnormalities CV collapse: Peaked T waves (6–7 mEq/L) ST depression Prolonged P-R interval and widened QRS (10–12 mEq/L) Ventricular fibrillation or…