ANESTHESIA - FLUID MANAGEMENT

ANESTHESIA ELECTIVE SELF-ASSESMENT AND STUDY QUESTIONS

Consider the following problems regarding fluid management and invasive hemodynamic monitoring.

1. Calculate the body fluid deficit for a 5 year old 20 kg child who has been NPO for 8 hours. What is this patient's blood volume? Why is this important to know? How do you asses and replace intra-op fluid and blood losses?
2. During repair of an AAA, there is an acute blood loss of several units of blood. What are your concerns regarding massive transfusion?
3. A 70 yr old with known cardiomyopathy with an EF of 20% presents with bowel obstruction for emergency ex. Lap. What invasive monitoring would you use? What special complications must you consider with these monitors? Review the insertion techniques for these invasive lines. You place a pulmonary artery catheter without complications - the cardiac output is 4 L/min and the heart rate is 80/min. What is the calculated stroke volume? If the patient's Oxygen saturation is 95% and the Hgb is 10 and the PaO; is 90.....calculate the O; carrying capacity? What is a "wedge" pressure and what does it reflect? Would a central venous pressure give you the same information?