Canadian Medical Association journal
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Mechanical ventilation and respiratory disease impose both theoretical and practical limitations on the interpretation of hemodynamic measurements. To properly interpret such information a thorough understanding of the circulatory changes associated with normal breathing, mechanical ventilation and respiratory disease is vital. There are a variety of factors involved in patients with obstructive lung disease and those receiving mechanical ventilation that complicate the usual interpretation of hemodynamic data obtained from flow-directed catheters. An awareness of the potential pitfalls of hemodynamic monitoring in such situations is important in the efficient use of the hemodynamic data obtained.
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Letter Case Reports
Cardiopulmonary resuscitation and airway obstruction.
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Hemodynamic monitoring and care of the patient at high risk for anesthesia require a careful and systematic approach. During preoperative evaluation the patient at increased risk must be identified and correctable problems must be solved. The patient's current medications must be reviewed because they may influence the choice of anesthetic approach and may alter the physiologic response to the stresses commonly associated with anesthesia. ⋯ The stresses during emergence from anesthesia contribute to lability of the cardiovascular status and hypoxemia. The period of risk does not conclude with immediate recovery from anesthesia but extends through the postoperative phase. Careful monitoring and attention to the control of pain, prevention of hypotension and hypertension, adequate oxygenation, early mobilization and resumption of the administration of cardiac medications are important factors in a successful outcome.