Key Points ▪ Most fetal anomalies are not appropriate for in utero treatment. A condition appropriate for fetal treatment should cause ongoing irreversible harm to the fetus that is mitigable by early treatment before the fetus can tolerate ex utero…
Key Points ▪ The normal physiologic changes of pregnancy begin in the first trimester, affect all organ systems, and alter pharmacokinetic and pharmacodynamic responses to many drugs commonly used in anesthesia. ▪ Maternal-fetal exchange of most drugs and other substances…
Key Points ▪ The shortage of organs available for transplantation is a worldwide problem. ▪ The discrepancy between the number of patients waiting for organ transplantation and the available organs remains significant, but has narrowed since 2013. ▪ Most organs…
Key Points ▪ Survival after abdominal organ transplantation continues to improve. ▪ The imbalance between organ supply and demand is increasing as new indications emerge and transplantation is offered to growing numbers of older candidates. ▪ To increase the supply…
Key Points ▪ Innervation of the intraabdominal components of the genitourinary system—the kidney and the ureter—is primarily thoracolumbar (T8-L2). The nerve supply of the pelvic organs—the bladder, prostate, seminal vesicles, and urethra—is primarily lumbosacral with some lower thoracic input. ▪…
Key Points ▪ In the United States more than two out of three people are overweight or obese. Worldwide, more people are obese than are malnourished. Obesity is becoming the largest single preventable cause of death and represents major morbidity…
Key Points ▪ For the purposes of planning a strategy for controlling intracranial pressure (ICP), the four subcompartments of the intracranial space should be considered: cells, interstitial and intracellular fluid, cerebrospinal fluid (CSF), and blood. ▪ The clinician should make…
Key Points ▪ Perioperative management of patients undergoing vascular surgery requires an understanding of the underlying pathophysiology of the specific vascular lesion. ▪ Major vascular surgery is particularly challenging to the anesthesiologist because these are high-risk operations in a patient…
Key Points ▪ Cardiac arrhythmias are caused by disorders of impulse formation, disorders of impulse conduction, or both. Cardiac arrhythmias may be life-threatening because of a reduction in cardiac output and/or myocardial blood flow or precipitation of a more serious…
Key Points ▪ Common cardiac surgical procedures in adults include coronary revascularization with either cardiopulmonary bypass (CPB) or off pump, as well as cardiac valve repair or replacement for valvular regurgitation or stenosis, surgical management of heart failure (e.g., ventricular…