L7: Anesthesia Emergency and Complication (Shih) Flashcards
components of hypoxia***
- dec. FiO2 (fraction of oxygen in the space being measured; air having hard time getting to lungs)
- hypoventilation (reduced amount of air enters the alveoli –> increased CO2 and decreased O2)
- V/Q mismatch
causes of drop in FiO2
esophageal entubation
airway obstruction (ie. neoplasia, complete collapse, etc.)
tracheal collapse
tx:oxygen mask, intubation to increase proportion of O2 to N2 in inspired air
why is hypoventilation less of a concern when patient intubated?
there is a higher percentage of oxygen delivered than required
what can cause hypoventilation?
anesthesia
sedation ie. propofol
hypothermia
what can cause V/Q Mismatch?
pneumonia
pulmonary edema
PTE
(also: Cushings, trauma, low CO, hypertension, etc.)
tx for V/Q mismatch if problem is perfusion:
increase CO
tx for V/Q mismatch if problem is ventilation:
intubate, O2 therapy, etc.
V/Q mismatch***
- perfusion without ventilation or vice versa
- CO2 and O2 levels normal in the lung, but O2 not diffusing into the capillary
- either air or blood doesn’t reach alveoli**
3 reasons for hypotension**
sepsis
cardiogenic shock
hypovolemic shock
how does cardiogenic shock cause hypotension
- heart weak and less blood comes out of artery (drop in systemic arterial pressure)
- pressure in venous system higher
- tx: epi, dobutamine, dopamine (makes heart “suck” more blood out of venous system)
why colloids not good for septic patients
can cause acute kidney injury (also have risk of clotting in hemorrhaging patients)
how to treat hypovolemic shock
fluids
lack of protein in blood –>
hypotension (fluid rushes out of blood because protein no longer holding it in)
-tx: colloid fluids
when tx with blood products?
when Hct/PCV low
name 4 inotropes
(an agent that alters the force or energy of muscular contractions) Epi NE Dobutamine Dopamine
