While on cardiopulmonary bypass, you notice the MAP has dropped from 76 mmHg to 58 mmHg. The perfusionist has administered a phenylephrine bolus without improvement. On examination, the patient’s face appears plethoric with a ruddy red-purple coloration, mild facial edema, and jugular venous distention. The most likely cause is:
Read DetailsYou are called to the PACU for a patient who is experiencing chest pain. The nurse reports that the patient did well in surgery and that the only significant medical history is aortic stenosis with a valve area of 0.7 cm². The nurse also reports treating some moderate post-op pain with 4 mg of morphine. You observe the patient’s vital signs on the monitor and note a HR 92, BP 99/53, SpO2 98% on room air. You decide the treatment for the patient’s chest pain is
Read DetailsYou are a CRNA giving a break to a colleague who is doing a non-elective emergency case. The colleague tells you the patient came up from the ED with an ischemic bowel. He reports that prior to surgery, all vital signs were normal and lung sounds were clear with a normal heart rhythm and a murmur. The colleague says the patient has been hypotensive in the OR, so he floated a PA catheter. He reports that pulmonary capillary wedge pressures have been 25 mmHg or greater. You believe the hypotension could be from:
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