A 67-kg, 52-year-old man is undergoing heart transplantation. After implantation of the donor heart and discontinuation of cardiopulmonary bypass, isoproterenol is administered intravenously to maintain heart rate greater than 100 bpm. During the next 10 minutes, blood pressure decreases from 105/55 mmHg to 75/40 mmHg. Heart rate is 102 bpm and cardiac output is 5.8 L/min. The most appropriate management is administration of
A previously healthy 28-year-old man is admitted to the emergency department with a probable opioid overdose. Arterial blood gas values are: PaO2 49 mmHg, PaCO2 76 mmHg, and pH 7.12 while breathing room air. Which of the following statements is true?
(A) Aspiration of gastric contents must have occurred
(B) Hypoventilation alone can explain the acidosis and hypoxemia
(C) The hypoxemia is probably due to noncardiogenic pulmonary edema
(D) Naloxone should be administered only if the patient is normothermic
A 30-year-old woman is undergoing laparoscopic tubal ligation. Thirty minutes after induction of general anesthesia, arterial oxygen saturation has decreased to 89%. Arterial blood gases at an FiO2 of 1.0 are PaO2 63 mmHg and PaCO2 40 mmHg; PetCO2 is 32 mmHg. Which of the following is the most likely cause?
(A) Carbon dioxide embolus
(B) Endobronchial intubation
(C) Hypoventilation
(D) Inadvertent application of high levels of positive end-expiratory pressure
Which of the following statements concerning the choice of nitroprusside or nitroglycerin to induce deliberate hypotension is true?
(A) Nitroglycerin is more potent
(B) Nitroglycerin produces hypotension by acting on both arterial and venous capacitance vessels
(C) Nitroprusside produces less rebound hypertension on discontinuation
(D) The toxic effects of nitroprusside are independent of dose
(E) The therapeutic effects of nitroprusside may persist on discontinuation
B
If the low-pressure alarm of an anesthesia circuit is broken, which of the following monitors will provide the earliest indication of a disconnected ventilator hose?