Ten days after sustaining burns over 40% of his body surface area, a patient requires greater than expected doses of vecuronium for adequate relaxation of skeletal muscle. The primary cause is increased
A 100-kg, 42-year-old woman received enflurane and oxygen for clipping of an intracranial aneurysm lasting eight hours. In the first two postoperative hours, urine output is 2 liters. Serum sodium concentration is 152 mEq/L. Urine osmolality and central venous pressure are low. Which of the following is best used to establish the diagnosis?
Compared with adults, neonatal respiratory function is characterized by
A 65-year-old man undergoes prostatectomy in the lithotomy position under spinal anesthesia using bupivacaine 12 mg. Ten hours later, he reports that his left foot is numb. Examination shows decreased pinprick sensation over the lateral dorsal aspect of the left foot; dorsiflexion is limited. Which of the following is the most likely cause?
During cardiopulmonary bypass at a nasopharyngeal temperature of 28°C and a hematocrit of 20%, temperature-corrected PaCO2 is 50 mmHg and uncorrected PaCO2 is 60 mmHg. The most appropriate management is to
A patient being mechanically ventilated in the ICU requires wound debridement twice daily. Each of the following agents would be appropriate for induction of brief general anesthesia EXCEPT
A 67-kg, 52-year-old man is undergoing heart transplantation. After implantation of the donor heart and discontinuation of cardiopulmonary bypass, isoproterenol is administered intravenously to maintain heart rate greater than 100 bpm. During the next 10 minutes, blood pressure decreases from 105/55 mmHg to 75/40 mmHg. Heart rate is 102 bpm and cardiac output is 5.8 L/min. The most appropriate management is administration of
A 60-year-old man with type II diabetes mellitus requires emergency incision and drainage of a perirectal abscess. Laboratory studies show a serum glucose concentration of 850 mg/dl and a pHa of 7.30. The most appropriate management is administration of regular insulin and which of the following infusions?
A 55-year-old man is undergoing craniotomy in the sitting position. Mean arterial pressure is 75 mmHg; arterial blood gas values are PaCO2 41 mmHg and pH 7.37. End-tidal CO2 is 7 mmHg. Which of the following is the most likely cause of the increased PaCO2 to PetCO2 gradient?
A 35-year-old woman who takes a diuretic daily for chronic hypertension has a serum potassium concentration of 3.1 mEq/L on the morning of an elective hysterectomy. An EKG shows left ventricular hypertrophy. The most appropriate management is to