BUMC Basics.pdf - Anesthesia Home
BUMC Basics.pdf - Anesthesia Home
BUMC Basics.pdf - Anesthesia Home
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43<br />
Nitroglycerine (Onset in 2-5 min) 5-100 mcg/hr<br />
(Tridyl): IV and titrate to keep desired MAP<br />
**Specific Conditions and Agents to Use:<br />
• In HTN Encephalopathy, use Nitroprusside and if that<br />
fails then Beta-Blocker or Nicardipine<br />
• In Subarachnoid Hemorrhage, use Nimodipine and if<br />
that fails then Beta-Blocker or Nicardipine<br />
• In CVA or aortic dissection, use Beta-Blocker and if that<br />
fails then Nitroprusside<br />
• In ARF, use Nicardipine and if that fails then Fenoldopan<br />
• In Cardiac Ischemia use Nitroglycerine + Beta-Blocker<br />
and if that fails then Nitroprusside<br />
• In post surgical patient, use Fenoldopam.<br />
PULMONARY EDEMA<br />
Causes — Revolves around three major organ systems<br />
Cardiogenic: Valvular abnormalities (acute MR, acute<br />
AR), MI/CAD, new onset arrhythmias,<br />
severe HTN, diastolic/systolic<br />
dysfunction w/ volume overloaded state,<br />
and pericardial dz. Usually must have<br />
some underlying cardiac disease<br />
(systolic/diastolic dysfunction) and<br />
another one of the other causes<br />
compounded to put pt. into cardiogenic<br />
pulmonary edema. Will have elevated<br />
PCWP >18mmHg.<br />
Pulmonary: Disruption of alveolocapillary barrier<br />
dysfunction (ARDS, trauma, aspiration,<br />
PE, and goodpastures); PCWP<br />
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