Monitoring during critical events:
The massively bleeding patient -- Myocardial ischemia: monitoring to diagnose ischemia: how do I monitor therapy? -- Monitoring for suspected pulmonary embolism -- Anaphylaxis: what is monitored to make a diagnosis? How is therapy monitored? -- Cardiac arrest and monitoring -- Performing a complete...
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2001
|
| Series: | Anesthesiology clinics of North America
19,4 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Summary: | The massively bleeding patient -- Myocardial ischemia: monitoring to diagnose ischemia: how do I monitor therapy? -- Monitoring for suspected pulmonary embolism -- Anaphylaxis: what is monitored to make a diagnosis? How is therapy monitored? -- Cardiac arrest and monitoring -- Performing a complete transesophageal echocardiographic examination -- Perioperative hypoxia: the clinical spectrum and current oxygen monitoring methodology -- Verification of endotracheal tube position -- Oliguria: a sign of renal success or impending renal failure? -- Arterial blood gas and pH analysis: clinical approach and interpretation -- Clinical approach to acid-base analysis: importance of the anion gap -- Neuromuscular blockade: inadvertent extubation of the partially paralyzed patient -- Spinal cord monitoring: somatosensory- and motor-evoked potentials -- Bispectral index monitoring. |
| Physical Description: | XVI S., S. 633 - 987 Ill., graph. Darst. |
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| adam_text | MONITORING DURING CRITICAL EVENTS
CONTENTS
Foreword xiii
Jonathan L. Benumof
Preface xv
William C. Wilson
CARDIOVASCULAR The Massively Bleeding Patient 633
John C. Drummond and Charise T. Petrovitch
Massive bleeding occurs when one or more blood volumes is lost
in a 24 hour period. The general objective in treating the mas¬
sively bleeding patient, in the setting of trauma or in elective
surgery, is to restore and maintain adequate oxygen delivery
to the tissues. Simultaneous with establishing adequate oxygen
delivery to the tissues, the clinician must be attentive to the
complications that may develop from the administration of large
volumes of blood products and fluids. This article describes rele¬
vant clinical endpoints and monitoring methods.
Myocardial Ischemia: Monitoring to Diagnose Ischemia:
How do I Monitor Therapy? 651
Kimberly L. Skidmore and Martin J. London
Myocardial infarction after noncardiac surgery is a rare event,
occurring in less than 0.7% of unselected patients; however, when
risk factors for coronary artery disease are present, this number
may increase. This article describes monitoring to diagnose ische¬
mia and techniques for monitoring therapy.
ANESTHESIOLOGY CLINICS OF NORTH AMERICA
VOLUME 19 • NUMBER 4 • DECEMBER 2001 vii
Monitoring for Suspected Pulmonary Embolism 673
Levon M. Capan and Sanford M. Miller
Perioperative pulmonary embolism may be caused by a number
of substances. Although many of these substances are specific to
a disease or a procedure (e.g., air or amniotic fluid), thromboem
bolism may occur in a wide variety of situations. As discussed in
this article, monitoring for and diagnosis of pulmonary embolism
represent a significant part of the responsibilities of the anesthesi¬
ologist in perioperative management of the surgical patient.
Anaphylaxis: What is Monitored to Make a Diagnosis?
How is Therapy Monitored? 705
Jerrold H. Levy and Aysegul Yegin
Anaphylaxis is one of the most life threatening emergencies that
can occur in the perioperative period. Multiple agents are poten¬
tially responsible, and nonallergic reactions can mimic anaphy¬
laxis. Developing a therapeutic plan for the acute therapy of
anaphylaxis is of vital importance. Prompt recognition, with ap¬
propriate and aggressive therapy, has the potential to help avoid
a disastrous outcome.
Cardiac Arrest and Monitoring 717
Charles W. Otto
Initial assessment to determine pulselessness, monitoring the sta¬
tus of the patient, and the effectiveness of resuscitation efforts
are integral parts of cardiopulmonary resuscitation. This article
focuses on aspects of monitoring during cardiopulmonary resus¬
citation: electrocardiography and assessment of the adequacy of
chest compressions.
Performing a Complete Transesophageal
Echocardiographic Examination 727
Jack S. Shanewise
Transesophageal echocardiographic (TEE) examination is a pow¬
erful and informative cardiac monitor and an important diagnos¬
tic tool for use during cardiac surgery. This article reviews how
to perform a comprehensive TEE examination on a patient in the
operating room and the important clinical uses of TEE during
critical events.
viii CONTENTS
RESPIRATORY
Perioperative Hypoxia: The Clinical Spectrum and
Current Oxygen Monitoring Methodology 769
William C. Wilson and Barry Shapiro
This article reviews the clinical manifestations of hypoxia and
the important oxygen monitoring considerations for anesthetized
patients. The article is divided into two parts: Part 1 reviews
the pathophysiology and physiologic compensations to systemic
hypoxia, and explores the problem of early diagnosis of hypoxia
and available treatment options; Part 2 examines oxygen monitor¬
ing modalities, including evaluation (skin and tissue appearance),
systemic blood gas monitoring (gold standard for determining
blood oxygenation), and pulse oximetry (noninvasive, but a de¬
layed indicator of oxygenation problems when patients are ad¬
ministered a high FIce) Additionally, available organ specific
monitoring modalities are reviewed. The considerations outlined
in this article are of utmost importance to all anesthesiologists
striving to provide top quality care to anesthetized patients.
Verification of Endotracheal Tube Position 813
M. Ramez Salem
There are two main goals to tracheal intubation: (1) to place the
tube in the trachea, and (2) to position the tube at an appropriate
depth inside the trachea. Sighting the tube passing between the
cords during direct laryngoscopy and visualization of the tracheal
rings and carina with a fiberscope after intubation are fool proof
methods of confirming tracheal intubation. In the nonarrested
patient, end tidal carbon dioxide monitoring quickly differenti¬
ates tracheal from esophageal intubation. In the critical care set¬
ting, a chest radiograph can easily detect malpositioned tracheal
tubes. Based on available information, two algorithms are pro¬
posed to assist the clinician, one for elective intubation and one
for emergency intubation.
SYSTEMIC/METABOLIC
Oliguria: A Sign of Renal Success or Impending
Renal Failure? 841
William C. Wilson and Solomon Aronson
Oliguria can be one of the first intraoperative clinical clues her¬
alding inadequate renal perfusion. This article reviews the identi¬
fiable factors known to increase the risk for perioperative renal
CONTENTS ix
insufficiency and the preoperative maneuvers that should be in¬
stituted to limit renal injury in high risk patients. Next, the physi¬
ology of urine formation, the influence of anesthesia on renal
perfusion, and the pathogenesis of perioperative acute renal fail¬
ure are discussed. The problem of intraoperative renal monitoring
is explored and a conceptual framework for verification, diagno¬
sis, and treatment of intraoperative oliguria is offered.
Arterial Blood Gas and pH Analysis: Clinical Approach
and Interpretation 885
Peter H. Breen
Arterial blood gas and pH analysis are performed during anesthe¬
sia or critical care medicine for (1) assessment of acid base bal¬
ance, (2) assessment of pulmonary oxygenation of arterial blood,
and (3) assessment of alveolar ventilation by measurement of
arterial blood Pco2. Total physiologic and alveolar dead spaces
are evaluated by comparing the alveolar Pco2 with the mixed
expired and mixed alveolar Pco2, respectively. This article pro¬
vides a clinical approach and interpretation of arterial blood gas
and pH analysis.
Clinical Approach to Acid Base Analysis: Importance of
the Anion Gap 907
William C. Wilson
NEUROLOGICAL Neuromuscular Blockade: Inadvertent Extubation of the
Partially Paralyzed Patient 913
David R. Bevan
This article reviews the incidence of residual block, particularly
with regard to different neuromuscular blocking drugs; describes
the consequences of small degrees of neuromuscular block and
their identification; and provides a reversal schema for the safe
pharmacologic reversal of neuromuscular blocking drugs.
Spinal Cord Monitoring: Somatosensory and Motor
Evoked Potentials 923
Peter de Haan and Cor J. Kalkman
Monitoring spinal cord function during procedures that pose a
risk for postoperative lower limb neurologic defects has gained
widespread acceptance. This article describes the techniques for
monitoring somatosensory and motor evoked potentials. Anes¬
thetic influences, indications, and limitations of both monitoring
X CONTENTS
modalities, during scoliosis surgery and thoracoabdominal aneu
rysm repair, are discussed.
Bispectral Index Monitoring 947
Carl Rosow and Paul J. Manberg
The Bispectral Index (BIS) is a newly processed electroencephalo¬
gram parameter that was specifically developed to measure the
hypnotic effects of anesthesia. Results from volunteer studies
demonstrate that BIS correlates well with clinical assessments
of sedation induced by sedative hypnotic drugs. Clinical utility
studies have shown also that BIS monitoring allows for better
titration of anesthesia, resulting in lower hypnotic drug use and
improved recovery. The data suggest that improved anesthetic
titration with BIS provides sufficient clinical and economic bene¬
fits to justify its routine use. This article summarizes the clinical
development and validation of BIS and describes how BIS moni¬
toring can be used to improve anesthetic outcomes.
Cumulative Index 2001 967
Subscription Information Inside back cover
CONTENTS xi
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| spelling | Monitoring during critical events William C. Wilson guest ed. Philadelphia [u.a.] Saunders 2001 XVI S., S. 633 - 987 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Anesthesiology clinics of North America 19,4 The massively bleeding patient -- Myocardial ischemia: monitoring to diagnose ischemia: how do I monitor therapy? -- Monitoring for suspected pulmonary embolism -- Anaphylaxis: what is monitored to make a diagnosis? How is therapy monitored? -- Cardiac arrest and monitoring -- Performing a complete transesophageal echocardiographic examination -- Perioperative hypoxia: the clinical spectrum and current oxygen monitoring methodology -- Verification of endotracheal tube position -- Oliguria: a sign of renal success or impending renal failure? -- Arterial blood gas and pH analysis: clinical approach and interpretation -- Clinical approach to acid-base analysis: importance of the anion gap -- Neuromuscular blockade: inadvertent extubation of the partially paralyzed patient -- Spinal cord monitoring: somatosensory- and motor-evoked potentials -- Bispectral index monitoring. Critical Care Monitoring, Physiologic Intensivmedizin (DE-588)4027263-1 gnd rswk-swf Monitoring (DE-588)4209015-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Intensivmedizin (DE-588)4027263-1 s Monitoring (DE-588)4209015-5 s DE-604 Wilson, William C. Sonstige oth Anesthesiology clinics of North America 19,4 (DE-604)BV000600896 19,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009653745&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Monitoring during critical events Anesthesiology clinics of North America Critical Care Monitoring, Physiologic Intensivmedizin (DE-588)4027263-1 gnd Monitoring (DE-588)4209015-5 gnd |
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| title | Monitoring during critical events |
| title_auth | Monitoring during critical events |
| title_exact_search | Monitoring during critical events |
| title_full | Monitoring during critical events William C. Wilson guest ed. |
| title_fullStr | Monitoring during critical events William C. Wilson guest ed. |
| title_full_unstemmed | Monitoring during critical events William C. Wilson guest ed. |
| title_short | Monitoring during critical events |
| title_sort | monitoring during critical events |
| topic | Critical Care Monitoring, Physiologic Intensivmedizin (DE-588)4027263-1 gnd Monitoring (DE-588)4209015-5 gnd |
| topic_facet | Critical Care Monitoring, Physiologic Intensivmedizin Monitoring Aufsatzsammlung |
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