Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit.

Slides:

Advertisements

Similar presentations

Suprastomal stent for management of tracheal compromise caused by subglottic and glottic stenosis. [Photo courtesy of Dr. Dana M. Thompson, Department.

Advertisements

Lateral (A) and coronal (B) views of the brain show the location of the primary sensory cortex. Note the cortical representation of body parts, the sensory.

Schematic of the Tec 6 vaporizer for desflurane

Schematic of the Tec 6 vaporizer for desflurane

This patient at 33 weeks was admitted in diabetic ketoacidosis (DKA)

Modern fluid warming systems have the capability to produce infusion rates up to 750 mL/min: A. Level 1® Fast Flow Fluid Warmer uses pressure technology.

Orbital fracture is a risk of endoscopic sinus surgery because of the proximity of the sinuses to the orbit (A, frontal view; B, coronal section). (Reproduced.

Esophageal pressure measurements in a patient with auto–positive end-expiratory pressure (auto-PEEP). Note that an esophageal pressure decrease of approximately.

Mapleson D circuit. Note that the fresh gas inlet (FGI) is distal to the adjustable pressure-limiting (APL) valve and proximal to the patient end. (Reproduced.

Comparison of lungs excised from rats ventilated with peak pressure of 14 cm H2O, zero positive end-expiratory pressure (PEEP); peak pressure 45 cm H2O,

(Copied with permission from: Latson, L. A. , & Prieto, L. R. (2007)

Vapor pressure, partial pressure, and concentration of inhaled anesthetics: The impact of atmospheric pressure on vaporizer output. Top. Variable bypass.

RIFLE criteria for acute kidney injury

Trauma bay configuration

Pathogenesis of bone diseases in chronic kidney disease

Noninvasive measurement of blood pressure

Example of 3 different types of ultrasound probes: (A) linear transducer, small footprint, "hockey stick" probe for superficial blocks and small working.

Three different types of ultrasound probes: (A) linear transducer, small footprint, “hockey stick” probe for superficial blocks and small working areas;

The relationship among infection, sepsis, and the systemic inflammatory response syndrome (SIRS). (Modified from the American College of Chest Physicians/Society.

Algorithm for preoperative management of patients taking antiplatelet therapy. ACS, acute coronary syndrome; BMS, bare metal stent; DES, drug-eluting stent;

Schematic of North American Dräger AV-E hanging bellows ventilator during inspiration. Solid gray area represents driving gas under pressure, which comes.

Vane anemometer. (Reproduced with permission from Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiology. 4th ed. New York, NY: McGraw-Hill; Figure.

Four options for weight loss surgery: (A) adjustable gastric banding; (B) Roux-en-Y gastric bypass; (C) gastric sleeve resection; (D) biliopancreatic diversion.

Relationship between duration of brachial plexus blockade of various local anesthetics and their degree of protein binding. [Reproduced with permission.

Multichannel polysomnographic recording

Source: Anesthesia Drugs and Drug Delivery Systems, Anesthesiology, 3e

Recommended algorithm for perioperative management of patients with pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) in.

Schematic representation of the main divisions of the respiratory tract. (Reproduced, with permission, from Junqueira LC, Carneiro J: Basic Histology:

Progressive changes in the electroencephalogram produced by ketamine

Guideline for contributing mechanism of pain state

Subdivision of conducting airways and terminal respiratory units

Postoperative considerations in a patient with an implanted cardioverter defibrillator. EMI, electromagnetic interference; ICD, implanted cardioverter.

Schematic diagram portraying the use of the fiberoptic bronchoscope to insert a left-sided double-lumen tube. A. The double-lumen tube can be put into.

Schematic diagram portraying the use of the fiber-optic bronchoscope to insert a left-side DLT. A. The DLT can be put into the trachea in a conventional.

Pulse oximeters provide data on arterial blood oxygen saturation as well as pulse rate. (A) Standard pulse oximetry unit. (B) Portable hand-held pulse.

Ejection fraction calculated using the disk summation method from 4-chamber end diastole (A), 2-chamber end diastole (B), 4-chamber end-systole (C), and.

Vapor pressure, partial pressure, and concentration of inhaled anesthetics: The impact of atmospheric pressure on vaporizer output. Top. Variable bypass.

This schematic depicts the steps taken to type, screen, and crossmatch blood. To determine ABO group and rhesus type, commercial anti-A, anti-B, anti-Rh(D)

Development of a pharmacokinetic model (using propofol as an example)

Development of a pharmacokinetic model (using propofol as an example)

A standard epidural order form.

Electrosurgical burn. If the intended path is compromised, the circuit may be completed through other routes. Because the current is of high frequency,

Criteria used to determine breath types during mechanical ventilation

Pedal venous pressure measurements with exercise

Fiber-optic orotracheal intubation during sedation and topical anesthesia. A. After sedation and application of topical anesthesia, an Ovassapian intubating.

Pressure trace obtained from an anesthetized dog as a Swan-Ganz catheter is advanced through the right atrium, the right ventricle, through the main pulmonary.

There is a good but not perfect correlation between anesthetic potency and lipid solubility. MAC, minimum alveolar concentration. (Modified and reproduced,

A: One-handed needle advancement; continuous pressure technique

The Yankauer-Gwathmey drop and vapor mask—similar to a kitchen strainer. (Reproduced from Flagg.34) Source: Anesthesia: Ketamine, Ether, and Halothane,

(Reproduced with permission from Amato AA, Russell JA

(Reproduced, with permission, from Emiliano Chavira, MD.)

A. Lightweight oxygen tank filled to 3000 psig can deliver 1000 L of gas at 1 atm pressure. B. Oxygen can be delivered at 50 psig via a diameter-index.

Schematic diagram showing a rigid ventilating bronchoscope system, which consists of the anesthesia circle system attached to a flexible connector that.

Paradoxical respiration in spontaneously breathing patients on their side. (Reproduced, with permission, from Tarhan S, Moffitt EA: Principles of thoracic.

Sources: (1) Global Strategy for the diagnosis Management and Prevention of COPD, Global initiative for Chronic Obstructive Lung Disease (GOLD)

Copyright © 2017 McGraw-Hill Education. All rights reserved

Schema depicting chronic obstructive pulmonary disease (COPD)

Measurement and Mechanism of Pulsus Paradoxus A, The examiner inflates the sphygmomanometer cuff fully, listens for Korotkoff sounds as the cuff is slowly.

The Bispectral Index Scale (BIS versions 3

Small bowel obstruction

Close-up views of the tips of a "cutting-tip" spinal needle: A

Number of uninsured persons in the United States, 1980 to 2014 (U. S

Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit.

acute, chronic, or acute on chronic.

Acute Respiratory Failure

Quantifying Pulsus Paradoxus

Oximeters CHEST Volume 94, Issue 5, Pages (November 1988)

Correlation between inspiratory capacity (IC)/total lung capacity (TLC) ratio and oxygen pulse at peak exercise in chronic obstructive pulmonary disease.

Pulse oximetry tracings from a 60-y-old woman with a COPD exacerbation who was admitted to the ICU in ventilatory failure. Pulse oximetry tracings from.

Clinical findings in patients with chronic obstructive pulmonary disease according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)

Presentation transcript:

Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit in ventilatory failure. A. The patient’s pulse oximetry tracing at the time of admission reveals respiratory variability in the pulse oximeter plethysmography tracing. Measured pulsus paradoxus at this time was 16 mm Hg. B. The patient’s pulse oximetry tracing after 12 hours of aggressive therapy. Pulsus paradoxus at this time was 8 mm Hg. Note the absence of respiratory waveform variation (RWV) in the baseline of the oximeter tracing after clinical improvement in airflow and resolution of elevated pulsus paradoxus. [Reproduced with permission from Hartert TV, Wheeler AP, Sheller JR. Use of pulse oximetry to recognize severity of airflow obstruction in obstructive airway disease: correlation with pulsus paradoxus. Chest. 1999 Feb;115(2):475-481.] Source: Monitoring the Anesthesia Patient, Anesthesiology, 3e Citation: Longnecker DE, Mackey SC, Newman MF, Sandberg WS, Zapol WM. Anesthesiology, 3e; 2017 Available at: http://accessanesthesiology.mhmedical.com/DownloadImage.aspx?image=/data/books/2152/longnecker3_ch28_f005.png&sec=164221090&BookID=2152&ChapterSecID=164142693&imagename= Accessed: November 07, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved