Case 37: Femoropopliteal Bypass Flashcards
What are the RCRI Criteria?
The Revised Cardiac Risk Index (RCRI) is a tool used to estimate a patient’s risk of perioperative cardiac complications.
Risk for cardiac death, nonfatal myocardial infarction, and nonfatal cardiac arrest:
0 predictors = 0.4%, 1 predictor = 0.9%, 2 predictors = 2.4%, ≥3 predictors = >5.4%
What is the ankle-brachial index?
- ABI is a noninvasive doppler measurement of the nakle and brachial systolic pressures, utilized to assess the presence and severity of popliteal artery disease.
- Normal ABI >1
- 0.5 = cludication, pain at rest
- <0.2 = ulceration and development of gangrenous extremity
In a patient with history of bundle branch block, what should you do prior to placing a CVP or Pulmonary Artery Catheter?
Place transvenous pacing pads on the patient given risk of progression to complete heart block with placement of pulmonary artery catheter.
How would you decrease risk of contrast induced nephrotoxicity?
- Ensure optimal volume status, hydration
- Ask surgeon to use non-ionic contrast
- Give bicarbonate to alkalanize the urine to fascilitate excretion
What are the types of Protamine reaction?
Three types
- Type 1
- Histamine release, mild histamine release, mild hypo
- Type 2
- Anaphylactic and anaphylactoid reaction
- Type 3
- Most severe form; Pulmonary HTN
What are the risk factors for patient developing post operative AKI?
- Underlying medical conditions, such as chronic kidney disease, diabetes mellitus, hypertension, cardiovascular disease, liver disease, and chronic obstructive pulmonary disease, are well-documented risk factors predisposing a patient to postoperative AKI
How is contrast induced nephropathy diagnosed?
Contrast induced nephropathy is diagnosed when a patient who recently received contrast dye has an increase in creatinine by >25% from baseline within 3 days of administration.
