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ASA Monitor February 2022, Vol. 86, 3. The following capnogram is MOST likely associated with which of the following? □ (A) Faulty inspiratory valve □ (B) Partially obstructed endotracheal tube □ (C) Leak in sampling line The time capnogram (Figure 1) can provide evidence of certain disease states and equipment issues. A faulty inspiratory valve makes […]
Read MoreAuthors: Alexander J. Rodriguez, MD and Christian O’Donnell, MD ASA Monitor February 2022, Vol. 86, 41. In anesthesia, the patient relationship typically ends once the operation is over. In internal medicine, it often begins well before or after a patient begins their surgical journey. Combined training in internal medicine and anesthesiology prepares one to tackle essentially […]
Read MoreASA Monitor February 2022, Vol. 86, 15. A patient undergoing major thoracic surgery has a urine output of 0.2 mL/kg/h. According to a recent study defining oliguria as a urine output less than 0.3 mL/kg/h, which of the following statements BEST describes the impact of urine output on the risk of postoperative acute kidney injury […]
Read MoreAuthors: Rachel Hadler, MD and Shahla Siddiqui, MD, MS, D.ABA, FCCM ASA Monitor February 2022, Vol. 86, 27–28. Case: A 65-year-old man with a previous medical history of hypertension, hyperlipidemia, and obesity is diagnosed with renal cell carcinoma with associated inferior vena cava (IVC) thrombus and concern for pulmonary metastases. He presents to the OR for nephrectomy […]
Read MoreAuthors: Krishnan S. Ramanujan, MD et al ASA Monitor February 2022, Vol. 86, 26. Medical professionalism is an evolving concept that reflects the myriad changes occurring in our health care system. In 2002, the American Board of Internal Medicine Foundation defined this concept in its physician charter, stating that medical professionalism “supports physicians’ efforts to […]
Read MoreAuthors: Matthew B. Allen, MD and Nicholas Sadovnikoff, MD, FCCM, HEC-C ASA Monitor February 2022, Vol. 86, 23–24. ASA guidelines for perioperative management of do-not-resuscitate (DNR) orders recommend that we revisit existing DNR orders prior to surgery and modify them as needed to align with patient preferences and clinical circumstances (asamonitor.pub/3lq2jgi). This “revisit and revise” or […]
Read MoreASA Monitor February 2022, Vol. 86, 14. New medical technology designed to better manage hypotension during surgery gains FDA clearance Directed Systems Limited, a medical software and data science company based in Cambridge, U.K., recently received U.S. Food and Drug Administration 510(k) clearance for a new version of its Hypotension Decision Assist (HDA) software, HDA-OR2. This […]
Read MoreAuthors: Rune P. Hasselager, M.D. et al Anesthesiology March 2022, Vol. 136, 459–471. Background Surgery is the main curative treatment for colorectal cancer. Yet the immunologic and humoral response to surgery may facilitate progression of micro-metastases. It has been suggested that epidural analgesia preserves immune competency and prevents metastasis formation. Hence, the authors tested the […]
Read MoreAuthors: Chung-Sik Oh, M.D., Ph.D. et al Anesthesiology March 2022, Vol. 136, 448–458. Background The antitumor effects of natural killer cells, helper T cells, and cytotoxic T cells after cancer surgery were reported previously. This study hypothesized that propofol-based anesthesia would have fewer harmful effects on immune cells than volatile anesthetics–based anesthesia during colorectal cancer […]
Read MoreAuthors: Clémence Erlich, M.D. et al Anesthesiology March 2022, Vol. 136, 472–481. Background Perioperative hypersensitivity reactions may be difficult to diagnose during general anesthesia. Postinduction hypotension is the most common sign but is not specific. It was recently suggested that low end-tidal carbon dioxide (ETco2) might be a marker of anaphylaxis (Ring and Messmer grades […]
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