Podcast
Questions and Answers
What term is used to describe the range of neurohumoral and inflammatory changes induced by trauma or surgery in the perioperative phase?
What term is used to describe the range of neurohumoral and inflammatory changes induced by trauma or surgery in the perioperative phase?
- Stress recovery
- Electrolyte disturbance
- Fluid balance
- Stress response (correct)
Which organ dysfunction is associated with disordered Na+ distribution, leading to profound effects on extracellular fluid volume?
Which organ dysfunction is associated with disordered Na+ distribution, leading to profound effects on extracellular fluid volume?
- Hepatic dysfunction (correct)
- Pancreatic dysfunction
- Lung dysfunction
- Muscle dysfunction
In what circumstance might patients depend on dialysis for fluid removal prior to surgery?
In what circumstance might patients depend on dialysis for fluid removal prior to surgery?
- End-stage renal disease (correct)
- Hypertension
- Cardiac dysfunction
- Diuretic treatment
How might chronic treatment with diuretics impact a patient's electrolyte balance preoperatively?
How might chronic treatment with diuretics impact a patient's electrolyte balance preoperatively?
What effect can overnight fasting have on a patient's normal blood volume ?
What effect can overnight fasting have on a patient's normal blood volume ?
Which group of patients may have a volume-contracted circulation preoperatively, making them more susceptible to intraoperative hypovolemia?
Which group of patients may have a volume-contracted circulation preoperatively, making them more susceptible to intraoperative hypovolemia?
What is the primary aim of the conservative responses invoked during absolute or relative hypovolemia?
What is the primary aim of the conservative responses invoked during absolute or relative hypovolemia?
Which of the following may lead to a systemic inflammatory response syndrome (SIRS) postoperatively?
Which of the following may lead to a systemic inflammatory response syndrome (SIRS) postoperatively?
What allows gut bacterial endotoxin to translocate into the systemic circulation, triggering systemic inflammation?
What allows gut bacterial endotoxin to translocate into the systemic circulation, triggering systemic inflammation?
How does hypervolemia caused by excessive fluid infusion contribute to endothelial dysfunction?
How does hypervolemia caused by excessive fluid infusion contribute to endothelial dysfunction?
What is one consequence of inflammation-related endothelial dysfunction?
What is one consequence of inflammation-related endothelial dysfunction?
Which hormone is primarily responsible for postoperative retention of water?
Which hormone is primarily responsible for postoperative retention of water?
What metabolic shift is mediated by catecholamine and cortisol release in response to tissue injury?
What metabolic shift is mediated by catecholamine and cortisol release in response to tissue injury?
What role does ADH play in maintaining fluid balance during the postoperative phase?
What role does ADH play in maintaining fluid balance during the postoperative phase?
Which response occurs when there's preservation of cardiac and brain perfusion during hypovolemia?
Which response occurs when there's preservation of cardiac and brain perfusion during hypovolemia?
What is the consequence of reduced plasma oncotic pressure related to inflammation?
What is the consequence of reduced plasma oncotic pressure related to inflammation?
What is the recommended duration for cessation of oral fluids before elective surgery in modern perioperative practice?
What is the recommended duration for cessation of oral fluids before elective surgery in modern perioperative practice?
Which electrolyte is predominantly lost in excess gastric fluid loss from obstruction, vomiting, or nasogastric suction?
Which electrolyte is predominantly lost in excess gastric fluid loss from obstruction, vomiting, or nasogastric suction?
which Pathologic effect cause electrolyte disturbances without external signs of fluid loss?
which Pathologic effect cause electrolyte disturbances without external signs of fluid loss?
What may contribute to impaired functional matching of local O2 delivery with tissue O2 requirements during surgery?
What may contribute to impaired functional matching of local O2 delivery with tissue O2 requirements during surgery?
What is a factor that influences intraoperative fluid balance by reducing cardiac preload and afterload?
What is a factor that influences intraoperative fluid balance by reducing cardiac preload and afterload?
What is a significant clinical manifestation of surgical blood loss?
What is a significant clinical manifestation of surgical blood loss?
How can the stress response during the perioperative phase be detrimental to patients?
How can the stress response during the perioperative phase be detrimental to patients?
Patients may enter the perioperative phase with established derangements of fluid and electrolyte balance. Hepatic, renal, and cardiac dysfunction are all associated with disordered Na+ distribution, which has profound secondary effects on ECF volume.
Patients may enter the perioperative phase with established derangements of fluid and electrolyte balance. Hepatic, renal, and cardiac dysfunction are all associated with disordered Na+ distribution, which has profound secondary effects on ECF volume.
How can chronic diuretic treatment affect a patient's electrolyte balance preoperatively?
How can chronic diuretic treatment affect a patient's electrolyte balance preoperatively?
What is a critical consideration for patients with end-stage renal disease who depend on dialysis for fluid removal relative to surgery?
What is a critical consideration for patients with end-stage renal disease who depend on dialysis for fluid removal relative to surgery?
What could help improve hemodynamics and lower serum creatinine in patients with excess fluid loss due to bowel preparation?
What could help improve hemodynamics and lower serum creatinine in patients with excess fluid loss due to bowel preparation?
Which electrolyte is most significantly lost in cases of large bowel losses such as diarrhea?
Which electrolyte is most significantly lost in cases of large bowel losses such as diarrhea?
What effect can sympathetic blockade caused by central neuraxial blockade have on cardiac output?
What effect can sympathetic blockade caused by central neuraxial blockade have on cardiac output?
Intraoperative fluid therapy may not always be effective due to impaired functional matching of local O2 delivery with tissue O2 requirements caused by:
Intraoperative fluid therapy may not always be effective due to impaired functional matching of local O2 delivery with tissue O2 requirements caused by:
opening of anatomic compartments lead to evaporative fluid loss from mucosal surfaces during surgery.what is the minimum loss during laparotomy?
opening of anatomic compartments lead to evaporative fluid loss from mucosal surfaces during surgery.what is the minimum loss during laparotomy?
Renal urine production suppression during surgery is related to perioperative Anti-Diuretic Hormone (ADH) secretion and effects of:
Renal urine production suppression during surgery is related to perioperative Anti-Diuretic Hormone (ADH) secretion and effects of:
Which scenario may result in a redistribution of fluid from the intravascular to the extracellular compartment during major surgery?
Which scenario may result in a redistribution of fluid from the intravascular to the extracellular compartment during major surgery?
What electrolyte is the least lost in cases of small bowel secretions ?
What electrolyte is the least lost in cases of small bowel secretions ?
What may lead to impaired functional matching of local O2 delivery with tissue O2 requirements during surgery?
What may lead to impaired functional matching of local O2 delivery with tissue O2 requirements during surgery?
What directly leads to mucosal necrosis in situations of hypovolemia-induced shunting of blood from the mucosa?
What directly leads to mucosal necrosis in situations of hypovolemia-induced shunting of blood from the mucosa?
Which response is aggravated by periods of hypotension and tissue hypoperfusion, leading to the potential aggravation of the inflammatory cascade?
Which response is aggravated by periods of hypotension and tissue hypoperfusion, leading to the potential aggravation of the inflammatory cascade?
What is a key consequence of reduced plasma oncotic pressure related to inflammation?
What is a key consequence of reduced plasma oncotic pressure related to inflammation?
What mechanism leads to edema in the lungs, bowel, and connective tissue as a result of inflammation-related endothelial dysfunction?
What mechanism leads to edema in the lungs, bowel, and connective tissue as a result of inflammation-related endothelial dysfunction?
What contributes to the release of cardiac natriuretic peptides that can further degrade the endothelial glycocalyx?
What contributes to the release of cardiac natriuretic peptides that can further degrade the endothelial glycocalyx?
Major surgery induces an inflammatory response that redistributes fluid from the intravascular to the extracellular compartment. when this is typically manifested?
Major surgery induces an inflammatory response that redistributes fluid from the intravascular to the extracellular compartment. when this is typically manifested?
What is a common manifestation of hypovolemia in the perioperative phase?
What is a common manifestation of hypovolemia in the perioperative phase?
Why may urine output not be a reliable measure of adequate end-organ perfusion postoperatively?
Why may urine output not be a reliable measure of adequate end-organ perfusion postoperatively?
Which statement is true regarding CVP as a marker of central venous volume?
Which statement is true regarding CVP as a marker of central venous volume?
What should be considered when assessing intravascular volume in perioperative fluid therapy?
What should be considered when assessing intravascular volume in perioperative fluid therapy?
What may not always accompany significant loss of blood volume in healthy patients ?
What may not always accompany significant loss of blood volume in healthy patients ?
What limitation is associated with using urine output as a measure of adequate end-organ perfusion?
What limitation is associated with using urine output as a measure of adequate end-organ perfusion?
What may contribute to reduced tissue oxygenation with impaired healing?
What may contribute to reduced tissue oxygenation with impaired healing?
How does positive fluid balance and weight gain in the early perioperative period impact postoperative morbidity?
How does positive fluid balance and weight gain in the early perioperative period impact postoperative morbidity?
Which side effect may be attributed to the amount of fluid given to a patient in the perioperative period?
Which side effect may be attributed to the amount of fluid given to a patient in the perioperative period?
What is a potential effect of inadequate correction of salt and water overload in the perioperative period?
What is a potential effect of inadequate correction of salt and water overload in the perioperative period?
What is a consequence of postoperative ADH secretion regarding fluid balance?
What is a consequence of postoperative ADH secretion regarding fluid balance?
Which parameter is considered a more useful marker when the relationship between right-heart and left-heart filling pressures is not reliable in the presence of cardiopulmonary pathologic processes?
Which parameter is considered a more useful marker when the relationship between right-heart and left-heart filling pressures is not reliable in the presence of cardiopulmonary pathologic processes?
Which technique identifies a mismatch between global O2 delivery and O2 usage at a whole organism level?
Which technique identifies a mismatch between global O2 delivery and O2 usage at a whole organism level?
Which technique is based on the association between inadequate gut perfusion and mucosal hypercarbia and acidosis?
Which technique is based on the association between inadequate gut perfusion and mucosal hypercarbia and acidosis?
What physiological effect can excessive intravascular volume have on the body?
What physiological effect can excessive intravascular volume have on the body?
What is the primary goal of perioperative fluid administration?
What is the primary goal of perioperative fluid administration?
What physiological response may be exacerbated by modest hypovolemia in the context of the surgical stress response?
What physiological response may be exacerbated by modest hypovolemia in the context of the surgical stress response?
What is a potential consequence of hypervolemia in the perioperative setting?
What is a potential consequence of hypervolemia in the perioperative setting?
What effect can hypovolemia have on global O2 delivery during surgery?
What effect can hypovolemia have on global O2 delivery during surgery?