Exam 2 - Neuro Flashcards
what should PaCO2 be maintained at in a neuro patient
30-35 mmHg
what will happen if the PaO2 < 50 mmHg in a neuro patient
CBF and ICP will increase
how can you prevent an increase in ICP
prevent hypoxemia < 50 mmHg
maintain adequate MAP 50-150 mmHg
maintain PaCO2 30-35 mmHg
prevent sig alterations in acid-base
what is the formula for cerebral perfusion pressure
CPP = MAP - ICP
how can you decrease extracellular fluid & prevent extravasation of fluids
mannitol or furosemide
what drug do you not want to give in traumatic brain injury patients
glucocorticoids
what is the Cushing’s reflex
bradycardia + hypertension
what type of fluids are preferred in neuro patients
colloids or blood products (stay in vasculature longer)
not crystalloids
what drugs to avoid in neuro patients
alpha-2 agonist - vasoconstriction/bradycardia
ketamine at anesthetic doses - ICP, IOP
why do you want to use low doses of inhalants in neuro patients
high doses cause a loss in autoregulation
want low dose < 1 MAC and balanced anesthesia
what premeds are good for neuro patients
opioid - methadone (less risk of vomiting)
benzodiazepines (anti-seizure)
what induction meds do you not want to use in neuro patients
ketamine
what maintenance meds can you use in neuro patients
low dose inhalant
propofol in dogs
fentanyl
why do you not maintain cats with propofol
prolonged recovery due to deficiency in glucuronidation
what is a risk of long anesthetic procedures
hypothermia
