Essence of Anesthesia Practice

Congestive Heart Failure

Risk Heart failure is a syndrome, not a disease. Incidence in USA: About 5.1 million, with more than 650,000 new cases diagnosed annually. Primary discharge diagnosis made in more than 1 million pts. 1-y and 5-y survival rates are 57%…

Congenital Pulmonary Cystic Lesions/Lobar Emphysema

Risk Cause of cardiorespiratory compromise 10–15% associated with CHD Perioperative Risks May develop worsening of cardiorespiratory status Contamination of unaffected lung by infected material from cyst Worry About Associated congenital anomalies Tension pneumothorax Cardiorespiratory compromise Overview Congenital Pulmonary Cystic Lesions…

Congenital Methemoglobinemia

Risk Navajo Indians, Alaskan Indians, and people of Puerto Rican and Cuban ancestry Normal life span (except for RCM type II) Perioperative Risks Oxidizing agents may increase MetHb to dangerous levels. Mild respiratory/cardiac depression may adversely affect pts with already…

Complement Deficiency

Risk C1 esterase inhibitor–deficiency incidence: 1:50,000-150,000 of the general population. Symptoms onset and diagnosis occur approximately at 20 y, and by 30 y approximately 98% of pts have symptoms. C2 deficiency incidence: <0.1% of the general population. Male versus female…

Cogan Syndrome

Risk Extremely rare: approximately 250 reported cases in the literature Mean presentation 30–40 y; however, cases in children and elderly reported No predilection for gender, race, or ethnicity Possible association with IBD Perioperative Risks Hemorrhage Thrombosis and organ/limb ischemia Adrenal…

Coarctation of the Aorta

Risk Sixth most-common congenital heart defect: 4:10,000 live births Recognized in 5–8% of pts with CHD Perioperative Risks Perioperative mortality: 1% when associated with no other cardiac anomalies in neonates, 10% when associated with a VSD, and 50% when associated…

Coagulopathy, Factor IX Deficiency

Risk Within USA, approximately 4000 persons are affected (20% of all hemophiliacs): incidence: 1:25,000–30,000 males; 75–100 are people born with the disease in USA each year. No racial prevalence. Highest prevalence overwhelmingly in males. Perioperative Risks Increased risk of hemorrhagic…

Cleft Palate

Risk 1 per 800 live births Frequently associated with cleft lip Gender predominance: Cleft lip/palate more common in males (2:1); isolated cleft palate more common in females (3:1) Perioperative Risks Morbidity and mortality extremely low; only five life-threatening cases of…

Cigarette Smoking Cessation

Risk In USA, approximately 21% of adults smoke tobacco; prevalence varies inversely with socioeconomic class; men > women (26% vs. 15%). Minorities more likely to smoke and less likely to quit. Prevalence among adults and teens declining, but growing evidence…

Cigarette Smoking

Risk Smoking is the most common cause of preventable death. Half of cigarette smokers die of a smoking-related disease; on average, smokers lose at least 10 y of life expectancy. In USA, incidence of smoking is 17.8%: 42.1 million smokers…