E_Share

 CONTROLLED HYPOTENSION IN THEORY AND PRACTICE* By J. P. PAYNE Department of Anaesthetics, University of Manchester rr has been said, with an element of truth, that progress in surgery is dependent upon advances in the field of anasthesia. The development of induced hypotension as an adjuvant to surgery is an excellent example of this interdependence. Fundamentally unrelated to anaesthesia, the techniques have been evolved almost exclusively by anaesthetists, who must be prepared to accept responsibility for the management of such cases. This, however, is but one example of the extension of the anaesthetist's duties in recent years. Today, he is expected to modify, disturb or odierwise alter basic physiological functions to meet the increasing demands of modern surgery. It behoves him therefore to be not only willing to accept these new responsibilities but also to be capable of undertaking them. Such capability presupposes a knowledge of basic physiological principles together wit

 Diabetic Ketoacidosis (DKA) Treatment & Management Treatment Approach Considerations Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. When treating patients with DKA, the following points must be considered and closely monitored: Correction of fluid loss with intravenous fluids Correction of hyperglycemia with insulin Correction of electrolyte disturbances, particularly potassium loss Correction of acid-base balance Treatment of concurrent infection, if present It is essential to maintain extreme vigilance for any concomitant process, such as infection, cerebrovascular accident, myocardial infarction, sepsis, or deep venous thrombosis. It is important to pay close attention to the correction of fluid and electrolyte loss during the first hour of treatment. This always should be followed by gradual correction of hyperglycemia and acidosis. Correction of fluid loss makes the clinical picture clearer and may be sufficien

 Diabetic Ketoacidosis (DKA) Overview Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel source. The overproduction of ketones ensues, causing them to accumulate in the blood and urine and turn the blood acidic. DKA occurs mainly in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Laboratory studies for DKA include glucose blood tests, serum electrolyte determinations, blood urea nitrogen (BUN) evaluation, and arterial blood gas (ABG) measurements. Treatment includes correction of fluid loss with intravenous fluids; correction of hyperglycemia with insulin; correction of electrolyte disturbances, partic