One of the anesthesiologist's greatest challenges is managing high-risk patients with acute or severe conditions.? This issue brings the anesthesiologist up to date on the most important and latest approaches to management of the sickest of patients.? Topics covered include managing the patient with sepsis or septic shock; anesthetic considerations for patients in respiratory failure; anesthetic concerns in patients presenting with renal failure; perioperative management of patients with liver failure; management of acute coronary syndrome in the OR; intraoperative concerns in patients presenting with sever aortic stenosis, aortic insufficiency, mitral regurgitation, or mitral stenosis; intraoperative management of patients with cardiac tamponade; anesthetic concerns in trauma victims requiring operative intervention; patients presenting with acute toxin indigestion; anesthetic concerns in patients with known neurologic insufficiency; management of endocrine insufficiency in the OR; and management of patients with mediastinal mass or tracheal stenosis.

Topics: Perioperative Care of Patient with Chronic Opioid Dependence; Anesthesia for Sites Outside the OR; New Developments in Anesthesia Ventilators and Machines; Future of Clinical Research/Ethics in Human Experimentation; Perioperative Glucose Management; Inflammatory Response to Anesthesia and Ways to Attenuate; Chemical Dependence; Anesthesia for Awake Craniotomies; Hyperthermic Peritoneal Chemotherapy; ACGME Competencies; Renal Function Update; Professionalism; New Developments in Neonatal Resuscitation; Automated Anesthesia

This issue brings together leading specialists from diverse fields including multiple subspecialties of anesthesiology, as well as surgery, cardiology, oncology, neurology, hospital medicine, endocrinology, and others. A multidisciplinary approach is essential to patient safety and optimal outcomes, so this valuable and unique monograph brings the anesthesiologist up to date on current integrated methods of preoperative assessment, consultation, and patient preparation for surgery. Article topics include preoperative evaluation and prep of the patient for cardiac surgery; noncardiac surgery in the patient with heart disease; identification and evaluation of the patient with lung disease; surgery on the patient with endocrine dysfunction; obesity, metabolic syndrome, and the surgical patient; surgery in a patient with liver disease; surgery in the patient with renal dysfunction; anemia in the preoperative patient; perioperative anticoagulant management; preop prep of the surgical patient with neurologic disease; and emergency and urgent surgery.

This issue of Anesthesiology Clinics prepares the anesthesiologist for the most challenging problems he will face with geriatric patients. Topics covered include delirium, postoperative cognitive dysfunction, fat embolism during hip replacement, Parkinson's disease and deep brain stimulator placement, diastolic dysfunction, atrial fibrillation, delayed arousal, severe atrial stenosis, multiple medications, informed consent and the ethical management of the older patient, dead bowel, acute perioperative beta-blockade in the older patient, urinary retention, and anesthetic care for patients with skin breakdown.

This issue of Anesthesiology Clinics covers the most cutting-edge topics in pediatric anesthesia that every practitioner must know to stay current in this changing field. Topics covered include new devices for difficult pediatric airway, the use of ultrasound in pediatric regional anesthesia, new concepts in treatment of pediatric traumatic brain injury, acute pain management, neurotoxicity of anesthetics in the developing brain, current thought on intraoperative awareness in children, current concepts on managing sepsis in children, the fontan patient, sedating the child with congenital heart disease, management of children with hemoglobinopathies, and current strategies for blood conservation in pediatric anesthesia.

Hemoglobin-based Oxygen Carriers is an exciting and evolving alternative to blood transfusion. This issue explores its potential with topics on: "HBOCs from Human or Bovine Hemoglobin," "Comparison of HBOCs to Stored Human Red Blood Cells," "HBOCs and Tissue Oxygenation," "HBOCs: Role in surgery, resuscitation or hemorrhagic shock?" and more!

Key Clinical Topics in Anaesthesia presents a brand new addition to the forthcoming Key Clinical Topics series. Key Clinical Topics in Anaesthesia provides a comprehensive overview of the subject, comprising over 100 carefully selected topics in alpha order that together provide an extensive understanding of anaesthetic management. This collection of highly practical guides systematically addresses anaesthetic management techniques for a large number of clinical settings, as well as summarising important areas such as Ethics and Nutrition. Edited by experienced specialists, with contributions from consultants who have recognised expertise in their field, this book provides an authoritative and up-to-date guide on anaesthesia. Designed to enable rapid access to core information, Anaesthesia offers effective exam revision and the ideal quick reference for day-to-day practice. Over 100 topics presented in alpha order, from Airway - Assessment to Ventilation Strategies Effective exam revision for FRCA and EDA candidates Succinct coverage of anaesthetic treatment modalities and complications Includes clinical photos and diagrams to improve understanding of concepts Contributions from experienced specialists to ensure authoritative, accurate content

For an anesthesiologist, though the challenge of managing an obstetric patient can be very satisfying and rewarding, it can also be extremely difficult given the potential for serious harm to the fetus and mother. For routine care, it is important to understand the risks and benefits of many practices to provide patients with informed decisions and the most satisfying experiences. There are also many less-usual patients and situations, however, that challenge the anesthesiologist's skills significantly. This issue of the Anesthesiology Clinics presents the most up-to-date information on both of these categories, and is written by an outstanding group of experienced clinicians from all over the world. Topics including high-risk analysis, use of simulators for training, major hemorrhage, off-labor-floor consultation, depth of anesthesia monitoring, pharmaceuticals, use of vasopressors, neurological infections after neuroaxial anesthesia, airway management, the HIV patient, ultrasound, and others.

This text contains the edited presentations of the 39th Annual Postgraduate Course in Anaesthesiology, February 1994. The chapters reflect new data concepts within the general framework of pain research and basic science, and clinical topics in pain management. The purpose of the textbook is to serve as a vehicle to bring many of the latest concepts in anaesthesiology to those who did not attend the conference, within a short time of the formal presentation. Each chapter is a brief by sharply focused glimpse of the current interests in anaesthesia. This volume, as well as past and future volumes, reflects the rapid and continuing evolution of anaesthestiology in the late-20th century.

"Anaesthesia and the Lung 1992" presents recent advances in the diagnosis, pre-, intra-, and postoperative anaesthetic management of patients with lung disease, presenting for pulmonary and non-pulmonary surgery. It also deals with ventilation - perfusion issues, the lung as a metabolic organ, the effects of anaesthesia on pulmonary mechanics and pulmonary blood flow. In addition, there are chapters that focus on hypoxia; regional differences in the lung; pulmonary surfactant; recent advances in the understanding of pulmonary edema; high altitude disease; anaesthesia and the control of breathing; recent development in oximetry; instrumentation designed to measure pulmonary oxygen tension, pO2 and pCO2 transcutaneously; differential lung ventilation; reactive airways; septic shock; the adult respiratory distress syndrome and numerous aspects of ventilatory support.

Decision making regarding fluid volume loading, fluid restriction, or administration of vasoactive drugs may vary among physicians, depending solely upon their clinical experience in the absence of evidence-based measurement. The initial distribution volume of glucose (IDVG) is believed to be clinically relevant as a marker of cardiovascular and fluid management in critically ill patients without a significant modification of glucose metabolism. This book covers all aspects of IDVG measurement, including the basic concept, its relationship with other fluid volumes, and the clinical application of this technique in the intensive care unit based on both the authors studies and their clinical experience with more than 4000 IDVG determinations. When the concept of IDVG is properly understood and its measurement is then performed routinely, daily fluid and cardiovascular management in critically ill patients can be improved based on evidence-based measurement."

For many of the millions of people who undergo anaesthesia each year, it is the source of great fear and fascination. In Counting Backwards, anaesthetist Henry Jay Przybylo has written an unforgettable account of the routine procedure's daily dramas and fundamental mysteries. Przybylo has administered anaesthesia more than 30,000 times on newborn babies, screaming toddlers and sullen teenagers, his own son and even a gorilla. With compassion and candour, he weaves his experiences into stories that explore the nature of consciousness, the politics of pain relief and the wonder of modern medicine. Through its intense and humane tales of mistakes, near-disasters, life-saving successes and moments of grace, Counting Backwards shines a light on a fascinating but unexplored corner of the medical world.

Sleep and anesthesia resemble in many ways at a first glance. The most prominent common feature of course is the loss of consciousness, i.e. the loss of awareness of external stimuli. However a closer look at the loss of consciousness reveals already a difference between sleep and anesthesia: anesthesia is induced by an anesthetic drug whereas we may fall asleep without external cause. Other questions may arise about the difference of the two effects: do we dream during surgery under anesthesia, do we feel pain during sleep? Essentially, we may ask: what is common and what are the differences between sleep and anesthesia? To answer these questions, we may take a look at the neural origin of both effects and the involved physiological pathways. In which way do they resemble? Moreover, we ask what are the detailed features of normal sleep and general anesthesia as applied during surgery and which features exist in both phenomena? If yes in which way?

To receive answers to these questions, it is necessary to consider several experimental techniques that reveal underlying neural mechanisms of sleep and anesthesia. Moreover, theoretical models of neural activity may model both phenomena and comes up with predictions or even theories on the underlying mechanisms. Such models may attack several different description levels, from the microscopic level of single neurons to the macroscopic level of neural populations. Such models may give deeper insight into the phenomena if their assumptions are based on experimental findings and their predictions can be compared to experimental results. This comparison step is essential for valuable theoretical models.

The book is motivated by two successful workshops on anesthesia and sleep organized

during the Computational Neuroscience Conferences in Toronto in 2007 and in Berlin 2009. It aims to cover all the previous aspects with a focus on the link to experimental findings. It elucidates important issues in theoretical models that at the same time reflect some current major research interests. Moreover it considers some diverse issues which are very important to get an overview of the fields. For instance, the book discusses not only neural activity in the brain but also the effects of general anesthesia on the cardio-vascular system and the spinal cord in the context of analgesia. In addition, it considers different experimental techniques on various spatial scales, such as fMRI and EEG-experiments on the macroscopic scale and single neuron and LFP-measurements on the microscopic scale.

In total all book chapters reveal aspects of the neural correlates of sleep and anesthesia motivated by experimental data. This focus on the neural mechanism in the light of experimental data is the common feature of the topics and the chapters. In addition, the book aims to clarify the shared physiological mechanisms of both phenomena, but also reveal their physiological differences.

"Perioperative Addiction" addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations.

Features:

Guidance for spotting and managing addicted patients

All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol

Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals

Fascinating overview of the long history of addiction

Genetic basis of addiction, and the range of pharmacological treatments for addiction

Anesthetics produce a reversible state of unconsciousness accompanied by ante- grade amnesia. This remarkable phenomenon brings great relief to surgical patients and wonder to clinicians and scientists. To date, we do not fully understand the mechanisms by which anesthetics ablate conscious sensation and memory. We are, however, making progress. This book presents original results as well as overviews of the current state of knowledge of the problem. It is authored by investigators who know the ?eld well; their research at a number of levels has contributed substantially to our c- rent understanding of anesthetic modulation of memory and consciousness. Most of the contributors were presenters at two workshops organized by Dr. Pearce and Dr. Hudetz at the 40th Annual Winter Conference on Brain Research, held at Snowmass Village, Colorado, from January 27 through February 2, 2007. One workshop focused on anesthetic modulation of consciousness and another on an- thetic modulation of memory. Seven of the chapters are based on material presented at these symposia - appropriately updated with new relevant ?ndings. This infor- tion is supplemented by chapters on anesthesia and sleep, computational analysis of the state of anesthesia, and the clinical phenomenon of "anesthesia awareness," a topic that has recently received much public attention. With these three additional contributions, the book thus includes 10 chapters.

Authored by the same stellar editors and contributors responsible for Kaplan's Cardiac Anesthesia, this title presents today's most essential clinical knowledge in cardiac anesthesia in a practical, user-friendly format. A manageable size and affordable price makes this an ideal purchase for every clinician who would like an economical yet dependable resource in cardiac anesthesia. Access to this product, which may be at the discretion of your institution, is up to 3 years of online and perpetual offline access. Elsevier reserves the right to restrict or remove access due to changes in product portfolio or other market conditions. Trusted authorities deliver the key cardiac anesthesia knowledge you need to know. A concise, user-friendly format and key points boxes in each chapter help you quickly locate crucial information. Annotated references guide you to the most practical additional resources. A portable size and clinical emphasis facilitates and enhances bedside patient care. Designed as a companion to Kaplan's Cardiac Anesthesia. Includes new topics vital to the current practice of cardiac anesthesiologists, such as transesophageal echocardiography; percutaneous valve procedures; new pacemakers and automatic internal defibrillators used for cardiac resynchronization therapy; left ventricular assist devices and extracorporeal membrane oxygenation therapy of heart failure; and patient safety issues. Focuses on today's most current and relevant therapies, including New Cardiac Drugs, and Heart Mate, Heart Ware, and Impella LVADs. Describes care of the cardiac patient in Hybrid Operating Rooms, Catheterization Laboratories, and Electrophysiology Laboratories, as well as the Cardiac Operating Rooms. Perfectly suited for residents, fellows, nurse anesthetists and anesthesiologists in practice.

This volume comprises the edited presentations of the 40th Annual Postgraduate Course in Anaesthesiology, February 1995. It reflects recent advances in this area. Obstetrical and paediatric patients constitute important and often challenging cases for the practicing anesthesiologist. This textbook is the 13th in a continuing series documenting the proceedings of the Postgraduate Course of the Department of Anesthesiology of the University of Utah School of Medicine.

Anesthesiology and the Cardiovascular Patient contains the edited presentations of the 41st Annual Postgraduate Course in Anesthesiology, February 1996. The chapters reflect new data and concepts within the general framework of the pathophysiology and management of surgical candidates with cardiovascular disease. The textbook will serve as a vehicle to bring many of the latest concepts in anesthesiology to those who did not attend the conference. Each chapter is a brief but sharply focused glimpse of the current interest in anesthesia. This volume, as well as past and future volumes, reflects the rapid and continuing evolution of anesthesiology in the late twentieth century.

Regional Analgesia in Obstetrics provides an account of the developments in the provision of regional analgesia and anaesthesia in obstetrics over the last decade. The book covers the attitudes to obstetric analgesia in different countries; the indications for regional analgesia in labour; the effects of regional analgesia on outcome; and operative delivery.

close circle of anaesthetic scientists but, with the help of computer technology, has greatly influenced the practice of the modern clinical anaesthesiologist. The efforts of anaesthesiologists, pharmaceutical companies, and the development of the internet has lead to a situation that now almost every anaesthesiologist can be in close contact to anaesthetic pharmacology computer simulation pro grams and target controlled infusion devices. These two tools allow us to in crease our understanding and improve the controllability of anaesthetic drug administration, on site, in the operating theatre. In Europe the growing enthusi asm regarding the study and practice of intravenous anaesthesia has lead to an increased output of manuscripts on this subject, the initiation of workshops on the pharmacology of anaesthetic agents and the formation of a society that embodies this spirit; the European Society for Intravenous Anaesthesia, the EuroSIVA. EuroSIVA The concept of EuroSIVA has been to provide a forum to co-ordinate, facilitate and promote high quality presentations in the area of intravenous drug admini stration. The first two meetings held in 1988 in Barcelona and 1999 in Amster dam achieved these aims. During the Barcelona and Amsterdam meetings pre senters of over 10 countries shared their knowledge with 250 and 400 partici pants, respectively. In addition to the EuroSIVA meetings the international board aims to promote education for those involved with intravenous anaes thesia."

In the past ten years, full-scale simulation training has become dramatically more evident in undergraduate and graduate medical education. This increase has been due pri marily to two factors: the development of new computer-driven technology and an interest in simulation-specific training techniques. Technologically, simulators have evolved from simple anatomical reproductions to full-scale accurate reproductions of anatomy and physiology powered by multiple computers. High-technology simulation centers run by teams of faculty are emerging as integral tools in fulfilling medical centers' educational missions. In addition, educational techniques specific to simulation, which have been de veloped and used by other industries for over half a century, are being applied to medical training. Aviation and aerospace have used sophisticated simulation since the 1950s to train pilots and astronauts. Extrapolating these methods for use in the medical world has been a natural course of events, particularly in specialties that require some of the same basic thought processes and interactions required of the pilot or astronaut. It is not surprising, then, that anesthesiology would be the medical specialty to take the lead in adding simula tion training to its educational programs. The anesthesiologist's job in the operating room is similar to that of a pilot in a cockpit, not in the specific tasks, but in decision making, technological and human interfaces, and crisis management."

Physicians, nurses, and safety experts comprehensively review sedation and analgesia to provide a completely new reference guide to safe sedation practices consistent with existing guidelines. Starting with an integrated review of the basic physiology and neurobiology of the sedated state, the authors proceed through clinical guidelines and practices, and conclude with an examination of quality-outcome measures and processes. They also review current mandates for safe sedation practices and address the key clinical issues of pharmacology, monitoring, and recovery. Special tables and figures throughout the book summarize protocols, regulatory requirements, recommended dosages, monitoring requirements, and quality assurance tools.

Anesthesia and the Central Nervous System is a textbook for a postgraduate course as well as a reference for all anesthesiologists which presents many of the latest concepts in anesthesiology within a brief formal presentation. An outstanding faculty presents topics relating to the biochemistry, physiology, and pharmacology of the nervous system, the anesthetic management of intracranial and spinal cord surgery, and the intensive care management of central nervous system disease. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia. This textbook is the eleventh in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City.