Anesthesia: A Topical Update - Thoracic, Cardiac, Neuro, Icu, And Interesting Cases (recent Advances In Anesthesiology)

This book provides an updated information about major systems for anesthesia in patients with concomitant diseases. Book chapters are designed to allow anesthesia providers to refresh their knowledge, and be able to focus on the current issues in these subspecialty areas. Readers will be able to approach anesthesia cases more effectively with the information provided. The chapters are written by eminent clinicians who are also outstanding teachers in their respective anesthesia training programs. Topics covered in this volume include: thoracic anesthesia, cardiac anesthesia, anesthesia in the ENT patient, neuroanesthesia, intensive care / ICU medicine, medical ethics, and interesting cases.The book serves as a handbook for advanced anesthesia professionals and a textbook for medical students. CONTENTS......Page 6 ACKNOWLEDGEMENTS......Page 15 DEDICATION......Page 16 List of Contributors......Page 17 INTRODUCTION......Page 18 AIRWAY......Page 20 Tracheostomy......Page 22 Tracheostomy Types......Page 24 LARYNGOLOGY......Page 26 HEAD AND NECK......Page 27 NIM TriVantage EMG Endotracheal Tube, Medtronic Xomed Corporation......Page 28 OTOLOGY......Page 30 PEDIATRICS......Page 31 EPIGLOTTITIS......Page 32 UPPER AIRWAY FOREIGN BODY......Page 33 Tonsillectomy......Page 35 Deep Neck Infections......Page 36 REFERENCES......Page 37 INTRODUCTION......Page 40 PREOPERATIVE CONSIDERATIONS IN THE PATIENT WITH LUNG CANCER......Page 41 Pulmonary Function Testing Suggestive of Increased Postoperative Morbidity......Page 42 Estimated Postoperative FEV1% = Preoperative FEV1 x (1 – fraction lung tissue resected/100)......Page 43 Preoperative Optimization......Page 44 INTRAOPERATIVE MONITORING......Page 45 Indications for Lung Isolation (One Lung Ventilation)......Page 47 Endobronchial Double Lumen Tubes......Page 48 Standard Fiberoptic Bronchoscopy Images......Page 50 Univent Tube......Page 52 Bronchial Blockers......Page 54 One Lung Ventilation and the Difficult Airway......Page 57 PHYSIOLOGY OF ONE LUNG VENTILATION......Page 59 VENTILATORY STRATEGIES DURING ONE LUNG VENTILATION......Page 62 Managing Hypoxemia......Page 63 Approach to Hypoxemia During One Lung Ventilation (Table 10)......Page 64 (Fiberoptic Bronchoscopy, Rigid Bronchoscopy, and Mediastinoscopy)......Page 65 ESOPHAGEAL SURGERY......Page 67 VIDEO ASSISTED THORACOSCOPY AND MINIMALLY INVASIVE ROBOTIC THORACIC SURGERY......Page 69 TRACHEAL RESECTION AND RECONSTRUCTION......Page 70 Conditions Associated with Need for Mechanical Ventilation After Thoracic Surgery......Page 72 PAIN MANAGEMENT......Page 73 Approaches to Postoperative Analgesia......Page 74 Pulmonary Complications......Page 75 Neurologic Injuries......Page 77 CONCLUSION......Page 78 REFERENCES......Page 79 INTRODUCTION......Page 87 CONTRACTILITY......Page 90 Interaction Between Preload, Afterload and Contractility......Page 91 Physiologic Response to Pressure Loading......Page 94 Physiologic Response to Volume Loading Conditions......Page 95 Ramifications of Pressure Load vs. Volume Load For Anesthesiologist......Page 97 AORTIC STENOSIS (AoS)......Page 98 MITRAL STENOSIS......Page 99 AORTIC INSUFFICIENCY (AoI)......Page 100 MITRAL REGURGITATION (MR)......Page 101 HYPERTROPHIC CARDIOMYOPATHY/HYPERTROPHIC OBSTRUC- TIVE CARDIOMYOPATHY (HCM/HOCM)......Page 102 HEART VALVES AND ANTICOAGULATION......Page 103 PACEMAKERS......Page 105 INOTROPIC SUPPORT – PHARMACOLOGIC......Page 107 VASOPRESSORS......Page 108 INOTROPIC SUPPORT – MECHANICAL......Page 109 SYSTOLIC HEART FAILURE......Page 110 DIASTOLIC HEART FAILURE......Page 111 Clinical Approach......Page 113 VENTRICULAR ASSIST DEVICES......Page 114 Intraoperative Care......Page 117 CONCLUSION......Page 118 ADDITIONAL MATERIAL USED FOR THIS WORK......Page 119 INTRODUCTION......Page 121 PREOPERATIVE CONSIDERATIONS......Page 124 Herniation Syndromes (Fig. 4)......Page 126 Laboratory......Page 128 Invasive Monitoring......Page 129 Neuromonitoring......Page 130 INDUCTION OF ANESTHESIA......Page 131 MAINTENANCE OF ANESTHESIA......Page 132 Unintended Wake-up During Neurosurgery......Page 134 Indication for Late Emergence......Page 135 Transfer to Neurosurgical ICU or Post Anesthesia Care Unit......Page 136 Management of Elevated ICP......Page 137 WHO Grading of CNS Tumors (Table 4)......Page 138 Infratentorial Tumors......Page 139 Intracranial Aneurysm and Cerebral Arteriovenous Malformation (AVM)......Page 140 Prevention of Rebleed After SAH......Page 141 Predictors of Mortality After Subarachnoid Hemorrhage......Page 142 Aneurysm Coiling......Page 143 Carotid Endarterectomy (CEA)......Page 144 Contraindications for CAS......Page 145 Spinal Cord Tumors......Page 146 Treatment......Page 147 Hydrocephalus – Two types......Page 148 Major Predictors of Delayed Emergence:......Page 149 Hypertension......Page 150 Arrhythmias......Page 151 Pituitary Tumor Resection......Page 152 Anesthetic Goals......Page 153 Preoperative Preparation and Evaluations......Page 154 Anesthetic Management......Page 155 Intraoperative......Page 156 Scalp Block......Page 157 Land Marks for an Effective Scalp Block (Fig. 5)......Page 158 Electrophysiological Monitoring and Functional Mapping......Page 160 Intraoperative Complications......Page 161 Anesthetic Agents Used – Pros and Cons......Page 162 ACKNOWLEDGEMENT......Page 163 REFERENCES......Page 164 Acute Respiratory Distress Syndrome (ARDS)......Page 165 Management of ARDS......Page 166 SHOCK......Page 167 SEVERE SEPSIS AND SEPTIC SHOCK......Page 169 Gastrointestinal Bleeding......Page 170 Hypertensive Emergency......Page 172 ACUTE KIDNEY INJURY......Page 174 Cocaine Intoxication......Page 176 Alcohol Withdrawal......Page 177 Toxic Alcohols......Page 178 CONCLUSION......Page 179 REFERENCES......Page 180 INTRODUCTION......Page 187 Volume-Controlled Ventilation......Page 188 Airway Pressure Release Ventilation......Page 189 High Frequency Oscillatory Ventilation......Page 190 NONINVASIVE VENTILATION......Page 191 RRT Subtypes......Page 192 Preoperative......Page 193 Intraoperative......Page 194 Adverse Effects......Page 195 Introduction......Page 196 Dosing of Antibiotics......Page 197 Timing of Antibiotic......Page 198 MRSA......Page 199 PERIOPERATIVE CONSIDERATIONS FOR NUTRITIONAL SUPPORT CRITICALLY ILL PATIENTS......Page 200 Consequences of Inappropriate Feeding......Page 201 Nutrition Route, Timing and Amount......Page 202 SEDATION......Page 204 Sedative Selection......Page 205 Sedation Scales......Page 206 Sedation Strategies......Page 207 Prevalence and Severity of the Problem......Page 208 Preparation......Page 209 Transport Equipment and Monitoring......Page 210 Standardization of Practices for In-Hospital Transport......Page 211 Causes and Consequences of Ineffective Handover......Page 212 REFERENCES......Page 214 INTRODUCTION [1 - 4]......Page 220 FUNDAMENTALS......Page 222 HISTORY AND PHYSICAL [1 - 5]......Page 223 THINK AND PLAN......Page 226 Intubation After Induction of General Anesthesia (Figs. 6 & 7)......Page 227 CONCLUSION......Page 228 ADDENDUM......Page 230 ACKNOWLEDGEMENT......Page 234 REFERENCES......Page 235 INTRODUCTION......Page 236 ETHICAL PRINCIPLES......Page 237 Respect for Personal Autonomy......Page 238 Shared Decision-Making......Page 239 DECISION-MAKING CAPACITY......Page 241 Adequate Disclosure......Page 243 CONSENT ELEMENTS: DECISION AND AUTONOMOUS AUTHORI- ZATION......Page 245 ADVANCE DIRECTIVES......Page 246 DNAR ORDERS IN THE OPERATING ROOM......Page 248 TREATMENT FUTILITY......Page 250 TREATMENT REDIRECTION AND PALLIATIVE CARE......Page 252 END-OF-LIFE CARE......Page 254 CONSENT FOR PUBLICATION......Page 256 REFERENCES......Page 257 INTRODUCTION......Page 263 Continuation......Page 264 Background......Page 265 DISCUSSION......Page 266 Continuation......Page 267 What would be the most likely working diagnosis for this patient?......Page 268 CASE 5......Page 269 Continuation......Page 270 Presumptive Diagnosis......Page 271 DISCUSSION......Page 272 Background......Page 273 DISCUSSION......Page 274 Continuation......Page 275 Discussion......Page 276 CONCLUSION......Page 277 REFERENCES......Page 278 SUBJECT INDEX......Page 280

This book provides an updated information about major systems for anesthesia in patients with concomitant diseases. Book chapters are designed to allow anesthesia providers to refresh their knowledge, and be able to focus on the current issues in these su