Arterial and venous thrombosis are major causes of morbidity and mortality. Venous thromboembolism (VTE) is the leading cause of preventable in-hospital mortality. Deep vein thrombosis (DVT) leading to VTE causes as many as 300,000 deaths annually in the United States…
Hemoglobin and Volume Replacement Therapies Historical Aspects of Transfusion The observation by Harvey in 1628 that blood circulates in a closed vascular system was pivotal in the practice of blood transfusion. As blood was recognized as vital to sustain life,…
Hemostasis is a critical homeostatic mechanism of survival that involves vascular, cellular, and plasma components that interact to stop bleeding. Vascular effects include vasoconstriction, expression of procoagulant factors such as tissue factor, and loss of normal anticoagulant functions of the…
Electrolyte concentrations are tightly controlled within physiologic ranges, which are essential for human health. The major electrolytes, sodium (Na + ), potassium (K + ), calcium (Ca 2+ ), phosphate (PO 4 3− ), and magnesium (Mg 2+ ), are…
Historical Perspective Plasma volume replacement is important in the perioperative period. The body and cardiovascular system are exposed to many challenges, such as neurohumoral adaptations, evaporation, fluid redistribution, and blood loss, that necessitate interventions. To achieve this, fluids are administered…
The kidney is a complex multifunctional organ that can be affected by anesthesia and the physiologic alterations of the perioperative period. The main functions of the kidney in the context of anesthesiology include (1) regulation of salt and water balance,…
Historical Perspective After antibiotics came into widespread use in the 1940s and 1950s, the possibility that giving antibiotics perioperatively might prevent surgical site infection (SSI) became a matter of debate. Miles and colleagues used a guinea pig model to demonstrate…
The concept of “immunosurveillance” describes a homeostatic balance whereby cells that undergo transformation into cancer cells are normally eliminated or kept in check by the immune system. In 1985 an autopsy study found that 36% of “normal” thyroid glands showed…
Physiology Hormone activity, increased metabolic demands, the gravid uterus, and biochemical changes related to the fetoplacental unit result in significant alterations in maternal physiology, anatomy, and pharmacology during pregnancy, as shown in Fig. 37.1 . These physiologic changes have a…
Dysfunction of the complex physiologic processes of the endocrine systems can lead to significant and potentially life-threatening problems. Administration of exogenous hormones or drugs that mimic or antagonize hormonal effects to manipulate the metabolic milieu is important in many therapies.…