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Thoracic Aortic Procedures – Arch or Hemiarch Procedures

What the Anesthesiologist Should Know before the Operative Procedure Open thoracic surgery for aortic repair or replacement is performed for the treatment of aortic aneurysms and dissections. A thoracic aortic aneurysm has a localized vessel diameter 50% more than the normal value (adjusted for age and height), whereas an aortic dissection is the structural violation…
Critical Care Medicine

Toxin-induced metabolic acidosis

1. Description of the problem What every clinician needs to know Metabolic acidosis is a common and serious presentation of several toxins. Toxin-induced metabolic acidosis can be due to multiple diverse pathways and can become become evident at various stages and time-frames of the poisoning. These include organic acid production through metabolic pathways, exogenous acid…
Hospital Medicine

Subarachnoid hemorrhage

Hemorrhagic strokes comprise 10-15% of all strokes. Subarachnoid hemorrhage (SAH) accounts for about 50% of hemorrhagic strokes. A thunderclap headache (TCH), which is a sudden and severe headache with maximal intensity at onset is a common presenting feature of SAH. About 80% of cases of non-traumatic SAH are due to the rupture of a saccular…
Critical Care Medicine

Respiratory Failure in Obesity

Acute Respiratory Failure in the Obese Patient Hypercapneic Respiratory Failure in the Obese Patient Acute Hypoxemic Respiratory Failure in the Obese Patient Postoperative Respiratory Failure Following Bariatric Surgery Postoperative Respiratory Failure Following Non-bariatric Surgery Respiratory Failure in the Bariatric Surgery Recipient Failure to Liberate from Mechanical Ventilation in the Obese Patient Synonyms Acute Respiratory Failure…

Fetal surgery

What the Anesthesiologist Should Know before the Operative Procedure Fetal surgery encompasses a broad range of possibilities, ranging from minimally-invasive procedures using 17-gauge needles, to complex cases that require two anesthesia teams, two operating rooms, and a team of neonatologists. These cases are truly multidisciplinary and communication between all teams is essential. An understanding of…
Obstetrics and Gynecology

Gestational Hypertension – Preeclampsia

Gestation hypertension – preeclampsia 1. What every clinician should know The term gestational hypertension-preeclampsia is used to describe a wide spectrum of disorders that are characterized by hypertension in pregnancy (Figure 1). As a group, hypertensive disorders during pregnancy are clinically heterogeneous with an estimated incidence of 6-30%, depending on parity, number of fetuses, body…

Mitral Valve Replacement

What the Anesthesiologist Should Know before the Operative Procedure Background Mitral valvular disease can be categorized as either stenotic or incompetent, albeit a third or more of patients present with both lesions. Mitral stenosis (MS) represents a pressure overload condition; whereas, mitral insufficiency or mitral regurgitation (MR) represents a volume overload state. As such, the…

Radical Hysterectomy and Abdominal Hysterectomy – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Hysterectomy is the surgical removal of the uterus. Removal of the uterus may be combined with the removal of the ovaries and/or fallopian tubes. The procedure may be done for a benign condition such as bleeding, endometriosis or leiomyosarcoma. Alternatively, this procedure may be part of…

Antepartum and Postpartum Hemorrhage – Prediction and Management

What the Anesthesiologist Should Know before the Operative Procedure Obstetric hemorrhage accounts for 25% to 30% of all maternal deaths worldwide and causes death in underdeveloped countries at a rate 100 times that in developed countries. Most deaths are due to postpartum hemorrhage. In developed countries, postpartum hemorrhage is the leading cause of major maternal…
Gastroenterology Hepatology

Approach to the patient with intestinal obstruction

Are you confident of the diagnosis? the lumen prevents normal flow of luminal contents. In a simple obstruction there is a single point of obstruction, whereas a closed-loop obstruction is caused by two distinct points of obstruction. A complete obstruction is present if there is no passage of intestinal contents beyond the point of obstruction,…
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