bkadry's documents

322 Page 1 Jonathan B. Mark, M.D. Monitoring With CVP and PAC Durham, North Carolina Complications of Central Venous Catheterization Central venous catheterization (CVC) remains a common procedure for the care of intensive care and highrisk surgical patients. The complications are well recognized, and the more common include: 1. 2. 3. 4. 5. 6. Bleeding (adjacent arterial injury, hematoma form...

321 Page 1 Acute Pain Pathophysiology Timothy J. Brennan, M.D., Ph.D. Iowa City, Iowa As anesthesiology expands its role perioperative medicine, our knowledge in acute pain management is highly regarded. In order to continue to in the front of acute pain management, mechanisms of acute pain must be explored and new analgesic drugs must be evaluated. Although many new discoveries are being mad...

320 Page 1 Recent Developments in Oxygen Monitoring Steven J. Barker, Ph.D., M.D. Tucson, Arizona In this lecture we shall review recent advances in the monitoring of patient oxygenation. We summarize the transport of oxygen from the atmosphere to the cell, and then describe monitors that function at four stages of the O2 transport process. Oxygen Transport in the Human Body At rest we consum...

319 Page 1 Key Issues in Negotiating Hospital Contracts Judith Jurin Semo, Esq. Washington, District of Columbia This lecture will review priority areas in negotiating anesthesiology services agreements with hospitals and ambulatory surgical centers (“ASCs”), highlight problematic provisions frequently proposed by hospitals, and suggest strategies to deal with the problem areas. For ease of r...

318 Page 1 Medical Decision Making: Evidence Based or Expert Opinion? Avery Tung, M.D. Chicago, Illinois 1. Introduction “I don’t believe in that study” Recent studies have established that physician compliance with the results of clinical studies, externally promulgated guidelines, and recommended practices, is poor. In the non-anesthesia domain, examples of noncompliance include below-optim...

317 Page 1 Julia E. Pollock, M.D. Regional Anesthesia - How to Make It Work Seattle, Washington Regional anesthesia has enjoyed a tremendous increase in popularity over the past two decades. The expanding involvement of anesthesiologists in the treatment of pain syndromes, the financial motivation to decrease hospitalization times, and the satisfaction for both patient and anesthesiologist ar...

316 Page 1 Inflammatory Response: Current Concepts Edward R. Sherwood, M.D., Ph.D. Galveston, Texas Introduction. Inflammation plays an important role in many pathophysiological processes encountered by anesthesiologists on a daily basis. Surgery, major trauma, sepsis and critical illness all have major inflammatory components. This review will address the basic mechanisms of inflammation and...

315 Page 1 Chronic Opioid Therapy for Non-Cancer Pain: An Evidence Based Look at the Issue Jane C. Ballantyne, M.D. Boston, Massachusetts Introduction Our question is whether the evidence available in the medical literature supports long-term opioid therapy for the treatment of non-cancer or non-terminal pain. Is the therapy efficacious, and does its efficacy outweigh its liabilities? A real ...

314 Page 1 Linda Shore-Lesserson, M.D. Hematologic Aspects of Cardiac Surgery Bronx, New York Introduction The hematologic management of the cardiac surgical patient entails a complex balance between extreme degrees of anticoagulation and the restoration of normal hemostasis after the procedure. These two opposing processes must be managed carefully and modified with respect to preoperative d...

313 Page 1 Current Controversies in Obstetric Anesthesia William R. Camann, M.D. Boston, Massachusetts In 1847, the Scottish obstetrician James Simpson administered ether to a woman during labor to treat the pain of childbirth. He was impressed with the degree of analgesia associated with the use of the drug. Nevertheless, he expressed concern about the possible adverse effects of anesthesia:...

312 Page 1 Pediatric Advanced Cardiac Life Support - 2006 Update Alan Jay Schwartz, M.D., M.S.Ed. Philadelphia, Pennsylvania Objectives: 1. Update pediatric basic and advanced cardiac life support treatment protocols. 2. Review causes of anesthesia-related cardiac arrest in the pediatric population. Introduction: More than 30 years ago the American Heart Association (AHA), through its emergen...

311 Page 1 New Age Neurosurgery: Avoiding Complications in Interventional Neuroradiology William L. Young, M.D. San Francisco, California This talk will outline the roles of the Anesthesiologist in the Interventional Neuroradiology (INR) suite with an emphasis on management strategies to prevent complications and minimize their effects if they occur. We will discuss fundamental management pri...

311 Page 1 David S. Warner, M.D. Managing Ischemic/Hypoxic Brain Insults Durham, North Carolina Introduction The perioperative environment poses inherent risk for insufficient metabolic substrate delivery to brain. Although preoperative diagnostics, monitoring, and surgical advances have undoubtedly reduced the frequency perioperative brain injury, such injuries still occur. In the perioperat...

311 Page 1 René Tempelhoff, M.D. Avoiding Complications in Neuroanesthesia St. Louis, Missouri Most complications in neuroanesthesia can be categorized in 2 groups: 1) Complications that are the direct result of our actions (errors of commission) or inactions (errors of omission) in patient management. 2) Complications resulting from the primary neurological ailment and the required surgical/...

311 Page 1 B. Steven Roth, M.D. Visual Loss after Spine Surgery Chicago, Illinois Introduction Visual loss after anesthesia and surgery is a rare, unexpected and devastating complication. In recent years, there has been heightened awareness of the possibility of visual loss after anesthesia for non-ocular surgery, and an impression, although yet unproven, that the incidence is on the rise.[1,...

310 Page 1 Jerrold H. Levy, M.D. Anaphylaxis and Adverse Drug Reactions Atlanta, Georgia INTRODUCTION Any substance that patients are exposed to in the perioperative period including drugs, blood products, or environmental antigens such as latex can produce anaphylaxis. Pharmacologic agents also have the potential to produce predictable and unpredictable adverse reactions. The most life-threa...

309 Page 1 Perioperative Considerations and Anesthetic Management of the Morbidly Obese Patient Thomas J. Ebert, M.D., Ph.D. Milwaukee, Wisconsin Obesity is a national epidemic with major health consequences. The morbidly obese (MO) patient only has a one in seven chance of a normal life expectancy (1). The cost of health care treatment for the obese population is 59% of national health care ...

308 Page 1 David J. Birnbach, M.D. Advances in Obstetric Anesthesia Miami, Florida LABOR ANALGESIA Introduction Labor results in severe pain for most women. The ideal labor analgesia technique should dramatically reduce the pain of labor, while allowing the parturient to actively participate in the birthing experience. In addition, it should have minimal effect on the fetus or the progress of...

307 Page 1 Mechanical Ventilatory Support in 2006: Getting the Most from the Ventilator Michael A. Gropper, M.D., Ph.D. San Francisco, California Respiratory failure is the leading cause for admission to most intensive care units (ICU’s). A number of recent advances have identified superior techniques for the management of patients with acute respiratory failure and the acute respiratory dist...

306 Page 1 ICU Sedation, Anxiolysis, and Neuromuscular Blockade Richard C. Prielipp, M.D., M.B.A., F.C.C.M. Minneapolis, Minnesota LEARNING OBJECTIVES: · Recognize the need for sedation, analgesia, and/or anxiolytic therapy in ICU patients · Understand how to utilize assessment scale(s) to monitor and control depth of sedation · Be familiar with kinetic properties of standard ICU sedatives, a...