A 3.3-kg neonate is brought to the operating room for repair of a left diaphragmatic hernia. A 3-mm endotracheal tube is placed to a depth of 9 cm. Initial arterial blood gas values from a right radial catheter while spontaneously breathing oxygen 50% are PaO2 82 mmHg, PaCO2 41 mmHg, pH 7.33, and base excess -5. After reduction of the hernia (during closure of the abdomen), vigorous attempts to expand the atelectatic lung are unsuccessful. The infant rapidly becomes very dusky, heart rate is 60 bpm, breath sounds are distant and squeaky bilaterally, and pulmonary compliance is decreased. Which of the following should be done first?
(A) Obtain a radiograph of the chest
(B) Place a chest tube on the left side
(C) Place a chest tube on the right side
(D) Withdraw the endotracheal tube 1 cm and suction
During controlled ventilation, which of the following will cause an increase in end-tidal carbon dioxide tension with a normal waveform on the capnograph?
(A) Bronchospasm
(B) Rapid blood loss
(C) Ventricular fibrillation
(D) Endobronchial migration of the endotracheal tube
A 28-year-old woman undergoes total thyroidectomy. The left recurrent laryngeal nerve is transected during the procedure. Which of the following findings is most likely postoperatively?
The lungs of a 7-kg infant are being ventilated with a volume-cycled ventilator at a rate of 20/min. The anesthetic circuit has a compressible volume of 5 ml/cm H2O, and the peak inspiratory pressure is 20 cmH2O. To achieve adequate ventilation, the ventilator tidal volume should be set at