In the following eight cases, we briefly describe anesthetic approaches, issues, and some potential complications. The reader will find many of the points discussed in the first two sections in the management of these cases. An alternative is a problem-oriented approach, namely first to read the cases and then, primed with many questions, delve into the first two sections.
Clinical talk teems with acronyms. Some abbreviations used throughout the cases include:
ABG: arterial blood gas.
ABP: arterial blood pressure (from an invasive arterial catheter).
ACE: angiotensin-converting enzyme.
ACT: activated clotting time.
Airway: read the Airway evaluation chapter to understand the examination.
aPTT: activated partial thromboplastin time.
ASA: American Society of Anesthesiology physical status classification.
BIS: bispectral index.
BP: blood pressure.
BUN: blood urea nitrogen.
CPAP: continuous positive airway pressure.
CPP: cerebral perfusion pressure.
CV: cardiovascular system.
ETT: endotracheal tube.
fb: finger-breadth (the width of an average adult’s finger).
HR: heart rate.
ICP: intracranial pressure.
NPO: nil per os= nothing by mouth.
NSR: normal sinus rhythm.
PAC: pulmonary artery catheter.
PACU: post-anesthesia care unit.
PCWP: pulmonary capillary wedge pressure.
Plt: platelet count.
PT: prothrombin time.
S1, S2, S3, S4: the first through fourth heart sounds, respectively
SpO2: oxyhemoglobin saturation by pulse oximetry.