Thoracic Key

COPD Age > 60 ASA class II or higher Functionally dependent Congestive heart failure Pulmonary hypertension Delirium Alcohol use Obstructive sleep apnea Albumin <3.6 g/dL Surgery factors: prolonged surgery more than 3…

Medication PO or IV Notes Phenytoin (Dilantin®) PO, IV Commonly used antiepileptic medication for IV administration. Side effects include hypotension and arrhythmia when given IV (must be given slowly IV)….

© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_26 26. Parkinson’s Disease Elizabeth Kaplan1   (1) Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle,…

© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_24 24. Cerebrovascular Disease Anna L. Golob1   (1) Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle,…

© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_23 23. Sickle Cell Disease Nason P. Hamlin1   (1) Division of General Internal Medicine, Department of Medicine, University of Washington,…

Hgb < 7–8 g/dL—red blood cell transfusion is indicated Hgb 8–10 g/dL—optimal transfusion threshold is unclear Hgb > 10 g/dL—red blood cell transfusion is usually not necessary Transfusion may be considered when the hemoglobin…

Early Within the first 1–2 days of starting heparin Seen in patients with prior exposure to heparin (usually in the preceding 3 months) and hence prior antibodies Usual Within 5–10…

Risk Type of procedure Examples Low Non-vital organs involved, exposed surgical site, limited dissection Lymph node biopsy, dental extraction, cataract extraction, most cutaneous surgery, laparoscopic procedures, coronary angiography Moderate Vital…

Etiology Description Consumption Seen in larger blood loss surgeries Occurs immediately after surgery Returns toward normal within 2–3 days Thrombocytopenia due to infection Associated with both viral and bacterial infections…

Drug Recommendation for practice Evidence levelb Glucocorticoids Continue; administer stress dose  5-ASA Discontinue on day of surgery and resume 3 days after surgery if normal renal function C Azathioprine, 6-MP…