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Cardiology

Use of the Echocardiogram to Define the Presence, Extent, and Etiology of Cardiac Dysfunction

Indications and patient selection Introduction Heart failure (HF) is a clinical syndrome characterized by breathlessness and fatigue. Hemodynamically, HF is caused by the inability to generate adequate cardiac output to meet end organ and peripheral perfusion demands, or to do so only at the expense of elevated cardiac filling pressure. The diagnosis of HF is…
Anesthesiology

Esophagogastrectomy/transhiatal and transthoracic

What the Anesthesiologist Should Know before the Operative Procedure Esophagogastrectomy is a high-risk surgical procedure most commonly performed in patients with esophageal cancer for treatment or palliation. Anesthesiologists caring for such patients should have a thorough understanding of the patients’ disease state for which the surgical procedure is indicated, relevant aspects of the planned surgical…
Anesthesiology

Obstructive lesions

What the Anesthesiologist Should Know before the Operative Procedure Airway obstruction in the pediatric population presents unique challenges to the anesthesiologist. It is imperative that the anesthesiologist has a thorough and complete understanding of the following prior to the procedure. The embryogenesis of the airway The anatomy of the pediatric airwayContinue Reading The challenge posed…
Critical Care Medicine

Hypoxemia & Hypercapnea

Hypoxemia and Hypercapnea Also known as Continue Reading Hypoxia Hypercarbia Hypercapnia Related conditions Cyanosis Anoxia Asphyxiation Suffocation Shortness of breath Dyspnea Apnea Respiratory distress Respiratory acidosis Respiratory failure Hypoventilation Pneumonia Acute respiratory distress syndrome (ARDS) Acute lung injury (ALI) 1. Description of the problem What every clinician needs to know Hypoxemia and hypercapnea are the…
Hospital Medicine

Glycemic control of the hospitalized patient

Glycemic Control of the Hospitalized Patient I. What every physician needs to know. A growing number of hospitalized patients have issues with glucose regulation. Though a significant portion have been diagnosed with diabetes, patients without a diagnosis of diabetes and increasingly the undiagnosed or ‘new onset’ diabetics, are frequently encountered in today’s hospitalized patient. The…
Anesthesiology

Surgical management of head and neck cancer – procedures

What the Anesthesiologist Should Know before the Operative Procedure Head and neck cancer patients pose major anesthetic challenges due to local invasion around the larynx and pharynx, in most cases, and due to changes caused by radiation or previous surgery in the region. A primary challenge for anesthesiologists with patients undergoing procedures around the head,…
Pulmonary Medicine

Thoracentesis, Pleural Biopsy, and Thoracic Ultrasound

General description of procedure, equipment, technique Thoracentesis is a percutaneous procedure in which a needle or catheter is passed into the pleural space for evacuation of pleural fluid. Most pleural effusions with a depth of greater than 1 cm (as determined by lateral decubitus chest radiography or ultrasound) may be safely tapped using a small-gauge…
Critical Care Medicine

Severe hypertension in the infant/child

Severe Hypertension Also known as: High blood pressure Continue Reading 1. Description of the problem Definitions Hypertension is defined as blood pressure (BP) that exceeds the 95th percentile for values stratified by age, gender and stature. Severe hypertension is defined as BP that exceeds the 99th percentile. These definitions are reiterated in the 2004 Fourth…
Anesthesiology

Abdominal Trauma – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Abdominal surgery following traumatic injury is performed primarily for two reasons: (1) bleeding, in which there is injury to one or more blood vessels or a solid organ (i.e. spleen, liver, kidney), or (2) contamination, in which there is a hollow viscus injury with intra-abdominal spillage…
Anesthesiology

ORIF of femoral shaft fracture

What the Anesthesiologist Should Know before the Operative Procedure? Femoral shaft fractures are usually associated with trauma, ranging from gunshot wounds to severe motor vehicle accidents with multiple associated injuries to “trips and falls” in osteoporotic elderly patients. While early external stabilization (bedside traction pin) is frequently performed, urgent repair is the general approach. “Pathological”…
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