A 2.8-kg 8-hour-old infant undergoes laparotomy for a ruptured omphalocele. Following primary closure of the abdominal wall, arterial blood gases are PaO2 40 mmHg (FiO2 0.6), PaCO2 55 mmHg, and pH 7.1. Blood pressure is 30/20 mmHg. After increasing the FiO2, the most appropriate action would be to
(A) obtain a radiograph of the chest immediately
(B) withdraw the endotracheal tube 1 cm
(C) assess the patient for coexisting congenital heart disease
(D) administer lactated Ringer's solution 15 ml/kg
After the bronchial and tracheal cuffs of a right endobronchial tube are inflated, ventilation through the tracheal lumen is not possible. This finding is most consistent with
(A) cuff occlusion of the right upper lobe bronchus
A 45-kg, 80-year-old woman undergoes pin fixation of the right hip in the lateral decubitus position under spinal anesthesia. One day after the operation, she cannot move her left ankle or foot actively. The most likely cause is
A full-term neonate has physical findings suggestive of congenital diaphragmatic hernia. Initial Apgar score is 2. Which of the following is the most appropriate initial management?
(A) Placement of an orogastric tube
(B) Insertion of a chest tube
(C) Controlled ventilation by face mask
(D) Controlled ventilation through an endotracheal tube
(E) Spontaneous ventilation through an endotracheal tube
Forty-eight hours after thoracotomy, a patient's T6-7 epidural catheter is removed and the distal 2 cm is noted to be missing. The patient felt no pain during removal and neurologic examination shows no abnormalities. After informing the patient, which of the following is the most appropriate next step in management?
Diffuse microvascular bleeding is noted in a patient who has received 25 units of whole blood for a liver resection. Platelet count is 40,000/mm3, prothrombin time is 18 sec, activated partial thromboplastin time is 54 sec, and serum fibrinogen concentration is 60 mg/dl. The most likely cause of the bleeding is