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Manual of Anaesthetic Monitoring in Small Animals

Stručný popis

Tato praktická publikace vysvětluje, jak monitorovat orgánové systémy zdravých a zdravotně oslabených pacientů během anestezie. publikace umožňuje veterinárním lékařům pochopit, co se v každém okamžiku děje, a minimalizovalo se riziko komplikací. Kromě toho je koncipována jako referenční publikace, které pomáhá zvládat nouzové situace. Autory jsou specialisté v oboru anesteziologie a poskytují podrobné informace o fyziologických aspektech anestezie spolu s četnými klinickými případy a reálnými situacemi.

Autor: Ignacio Sández Cordero(Editor)

Cena s DPH: asi 1767 Kč

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Základní informace

Nakladatel	Servet
ISBN	9788418339585
Vydání	2021
Vazba	pevná
Počet stran	192

Popis

This practical book explains how to monitor the organ systems of healthy and medically compromised patients during anaesthesia so as to help veterinary surgeons understand what is happening at every moment and reduce complications. In addition, it has been conceived as a reference book that can be consulted in emergency situations. The authors, who are specialists in the field, provide in-depth information about the physiological aspects of anaesthesia, together with numerous clinical cases and real situations.

Obsah

1. MONITORING AND COMPLICATIONS IN THE PERIANAESTHETIC PERIOD	2
Introduction	3
Objectives of monitoring during anaesthesia	3
Frequent complications and mortality during the perianaesthetic period	3
Adequate monitoring for each anaesthetic procedure	5
2. ASSESSMENT AND PRE-ANAESTHESIA CONSULTATION	8
Introducion	9
Pre-anaesthesia consultation	9
Pre-anaesthesia physical examination and anamnesis	11
Basal frequencis in the pre-anaesthesia consultation	14
Additional tests	15
First intention tests	15
Second intention tests	15
Anaesthetic risk	15
Preparation of a list of critical points	16
3. ANAESTHESIA RECORD	18
Introduction	19
Anaesthetic monitoring sheet	19
Optimisation of the anaesthesia record	21
Post-operative monitoring sheet	21
Monitoring sheet for sedation	21
Checklists	25
4. BASIC EXAMINATION OF THE PATIENT DURING THE PERANAESTHETIC PERIOD	28
Introduction	29
Evaluation of body condition (BC)	29
Auscultation	29
Cardiac auscultation	30
Peripherial pulse palpation	32
Mucosal color	32
Capilary refill time	34
5. CARDIOVASCULAR SYSTEM MONITORING	36
Introduction	37
Electrocardiogram (ECG)	37
Blood pressure	40
Noninvasive blood pressure measurement	40
Oscillometric method	40
Doppler method	41
Invasive blood pressure meassurement	41
Central venous pressure (CVP)	45
Relevance of CVP	45
Techniques to monitor CVP	45
Manometer water pressure gauge	46
Invasive pressure transducer	46
Monitoring of peripheral venous pressure (PVP) instead of CVP	47
Oxygen delivery to tissues	47
Importance of determining cardiac output (CO) and stroke volume (SV)	48
Changes in CO and SV during anaesthesia	48
Methods for determining cardiac output in veterinary medicine	49
Thermodilution	49
Transpulmonary thermodilution	50
Lithium dilution	50
Pulse contour analysis	50
Determination of cardiac output based on partial CO2	51
Bioimpedance and bioreactance	51
Transthoracic echocardiology	51
Transoesophageal echocardiography	51
Transoesophageal Doppler	52
Suprasternal Doppler ultrasound	54
Monitoring of preload status	54
6. RESPIRATORY SYSTEM MONITORING	60
Pulse oximetry	61
How it works	61
Limitations	63
Other uses of pulse oximetry	65
Capnography	66
Capnogram analysis	69
Clinical utility of capnography	69
Volumetric capnography	72
7. MECHANICAL VENTILATION MONITORING	74
Introduction	75
Physiology of spontaneous ventilation	75
Monitoring of vetilatory mechanics	76
Pressure-time curve	76
Volume controlled ventilation	76
Pressure controlled ventilation (PCV)	81
Flow-time curve	81
Volume-time curve	83
Pressure-time curve	83
Flow-volume loop	84
Compliance and resistance	84
Evaluation of the ventilation/perfusion (V/Q) ratio	85
Evaluation of alveolar collapse or pulmonary atelectasis in anaesthesia	87
Impact of mechanical ventilation of the cardiovascular system	88
Cardiovascular effects	88
Autonomous tone	88
Reduced venous return	88
Compensatory mechanism	88
8. MONITORING OF TEMPERATURE, HYPOTHERMIA AND HYPERTHERMIA	90
Physiology of thermoregulation	91
Tempreature monitoring	92
Hypothermia	93
Perioperative hypothermia	93
Hyperthermia	100
Causes	100
Consequences	101
Treatment	101
9. NERVOUS SYSTEM MONITORING DURING ANAESTHESIA	104
Introduction	105
Evaluation of the degree of hypnosis	106
Eyeball position and reflexes	106
Concentration of anaesthetiv agents	106
Evaluation of the electrical activity of the brain: electroencephalogram (EEG)	107
Evaluation of the degree of intraoperative analgesia	109
Blood pressure (BP) and heart rate (HR)	110
Plethysmographic curve	110
Parasympathetic tone activity (PTA)	111
Changes in BIS	112
Additional monitoring of the nervous system: interanial pressure (ICP) monitoring	112
10. MONITORING OF NEUROMUSCULAR FUNCTION	116
Introduction	117
Principles of neuromuscular monitoring	119
Nerve stimulation sites	119
Nerve stimulation patterns	120
Train of four	120
Quantitative monitoring of neuromuscular function	122
Reserval of neuromuscular block	123
Acetylcholinesterase antagonists or anticholinesterase agents	124
Molecular encapsulants	125
11. ARTERIAL AND VENOUS BLOOD GAS ANALYSIS	128
Introduction	129
Acid-base imbalances	132
Traditional method	132
Base excess	133
Anion gap	133
Stewart method	134
Gamblegrams	134
Assessment of oxygenation	134
Hypoxaemia	136
Oxygenation indices	138
Alveolar-arterial CO2 difference	139
12. LACTATE	140
Lactate production	141
Lactate removal	142
Removal by oxidation	142
Removal by gluconeogenisis	142
Use of lactate during stress	144
Measurement of lactate levels	145
Interpretation of lactate values	146
Prognosis and diagnostic value of lactate	148
13. POST-ANAESTHETIC MONITORING OF THE CRITICALLY ILL PATIENT	152
Introduction	153
Cardiovascular system	153
Respiratory system	154
Urine production	156
Blood tests	157
Temperature	157
Analgesia	158
Pain assessment/monitoring	159
Use of analgesics	159
Systemic analgesics	159
Locoregional analgesia	159
Other considerations	161
Glasgow Feline Composite Measure Pain Score: CMPS	162
Glasgow Canine Composite Measure Pain Score: CMPS	165
BIBLIOGRAPHY	168