There are several disadvantages of disadvantages of carbon dioxide : • High concentration causes narcosis. • It increases the cerebral blood flow and intracranial pressure. • It stimulates sympathetic nervous system, which may be dangerous in some patients already having systemic hypertension or myocardial ischaemia. • It sensitizes myocardium to externally administered catecholamines. • It […]
The physiologic changes in pregnancy occur in response to fetal development and eventual delivery. It is incumbent on the intensive care physician to have an understanding of the normal variants that occur in pregnancy to correctly interpret diagnostic tests and effectively treat clinical conditions. Some changes that occur in pregnancy include the following. Endocrine changes
Many common critical care drugs are among the safe drugs during pregnancy, whereas some should be used with caution and others avoided entirely. When treating pregnant patients, it is the physician’s responsibility to treat the mother as the primary patient. Fetal considerations are secondary to ensuring maternal well-being because maternal demise will generally result in
Autonomic dysreflexia is an acute syndrome that frequently occurs in spinal cord injury (SCI) patients with a level usually above T6. It is characterized by excessive unmodulated sympathetic outflow in response to noxious stimuli below the spinal cord level. This can lead to dangerous elevations of blood pressure with disastrous clinical sequelae. Pathophysiology of Autonomic
Malignant hyperthermia (MH) is a hypermetabolic disorder of skeletal muscle that is triggered in susceptible individuals by several inhalation anesthetic agents (sevoflurane, desflurane, isoflurane, halothane, enflurane, and methoxyflurane) and succinylcholine. These anesthetic triggers cause intracellular hypercalcemia in skeletal muscle by decreasing the uptake of calcium by the sarcoplasmic reticulum. The intracellular hypercalcemia activates metabolic pathways
Neuroleptic malignant syndrome (NMS) is a clinical syndrome consisting of four primary features: rigidity, altered mental status, hyperthermia, and autonomic instability. It occurs in the setting of the use of dopamine-blocking agents or the withdrawal of dopamine-enhancing medications. Neuroleptic malignant syndrome Epidemiology Incidence of Neuroleptic malignant syndrome is estimated at 0.1% to 2%. There is
Trichloroethylene Trichloroethylene is also called as Trilene. It is an inhalational anesthetic gas, which was widely used until recently. It is still used in some developing countries because of its cheap cost compared to the other halogenated inhalational anesthetics. Trichloroethylene Physical Properties • It is colorless liquid. • Odor is sweet. • Mildly irritant. •
Enflurane is not a very commonly used agent in the developing counties although its usage is on in America. It is a newer inhalational agent like that of halothane. Enflurane is halogenated ether. Enflurane Physical Properties : It is a Colorless gas. It has ethereal odor. It is Non inflammable at clinical concentration but inflammable
What is Chloroform Chloroform is a very toxic compound, which was used in the past as an anesthetic agent. Chloroform use in anesthesia is only of historical value, although it still has some applications outside the medical practice. It was available as a liquid in bottles that would be poured on to a cloth and
Cyclopropane is an anesthetic inhalational agent. It is a liquid agent stored in orange colored cylinders at 75 psi and delivered as gas. Among other halogenated inhalational agents used in anesthesia, Cyclopropane is one which is stored in cylinders at room temperature. Some of the important properties and characteristics of it are discussed below. • It is
