A 58-year-old man undergoes repeat coronary artery bypass grafting. Which of the following is LEAST likely to decrease the need for exogenous blood transfusion?
(A) Cell saver blood collection before and after cardiopulmonary bypass
(B) Epsilon-aminocaproic acid administered during cardiopulmonary bypass
(C) High-dose aprotinin administered during cardiopulmonary bypass
(D) Tranexamic acid infusion during cardiopulmonary bypass
(E) Desmospressin administered after cardiopulmonary bypass
E
Postoperatively a 70-kg patient has a serum sodium value of 130 mEq/L. To increase this value to 140 mEq/L would require the administration of how much sodium in mEq?
Addition of 20 cmH2O positive end-expiratory pressure to a patient receiving controlled mechanical ventilation decreases cardiac output and left ventricular function by
You are asked to evaluate a 2000-g male infant three hours after vaginal delivery because of a respiratory rate of 50/min, pulse rate of 115 bpm, and the following arterial blood gas values while breathing room air: PaO2 64 mmHg, PaCO2 43 mmHg, and pH 7.33. His mother received meperidine 75 mg two hours before delivery. Appropriate management includes
(A) administration of naloxone 50 mcg intramuscularly
(B) increasing the FiO2 to 0.4
(C) intubation and mechanical ventilation at an FiO2 of 0.5
(D) administration of oxygen 50% with 5 cm H2O continuous positive airway pressure
A 35-year-old patient with asymmetric septal hypertrophy (IHSS) is undergoing bladder suspension with sevoflurane 1%, nitrous oxide 50%, and oxygen 50%. Immediately after skin incision, blood pressure decreases to 90/60 mmHg and junctional tachycardia of 150 bpm is noted on the ECG. Which of the following is the most appropriate management?
In a patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Each of the following findings correctly identifies the associated fluid EXCEPT
(A) precipitation when mixed with an equal volume of thiopental — local anesthetic
A 157 cm (5 ft 2 in), 180-kg, 40-year-old woman has a PaO2 of 65 mmHg, a PaCO2 of 38 mmHg, and a pH of 7.43 while breathing room air preoperatively. The most likely cause of these values is
(A) decreased hypoxic ventilatory drive
(B) higher than normal oxygen extraction from blood
(C) lower than normal cardiac output
(D) lower than normal functional residual capacity