Pediatric Anesthesiology Review. Clinical Cases for Self-Assessment PDF
Preview Pediatric Anesthesiology Review. Clinical Cases for Self-Assessment
Pediatric Anesthesiology Review Clinical Cases for Self-Assessment Robert S. Holzman Thomas J. Mancuso Joseph P. Cravero James A. DiNardo Third Edition 123 Pediatric Anesthesiology Review Robert S. Holzman • Thomas J. Mancuso Joseph P. Cravero • James A. DiNardo Pediatric Anesthesiology Review Clinical Cases for Self-Assessment Third Edition Robert S. Holzman Thomas J. Mancuso Senior Associate in Perioperative Senior Associate in Perioperative Anesthesia Anesthesia Critical Care Medicine Boston Children’s Hospital and Pain Medicine Boston, MA Boston Children’s Hospital USA Boston, MA USA Joseph P. Cravero Senior Associate in Perioperative James A. DiNardo Anesthesia and Pain Medicine Senior Associate in Cardiac Anesthesia, Anesthesiologist-in-Chief Chief Division of Cardiac Anesthesia Boston Children’s Hospital Boston Children’s Hospital Boston, MA Boston, MA USA USA ISBN 978-3-030-60655-8 ISBN 978-3-030-60656-5 (eBook) https://doi.org/10.1007/978-3-030-60656-5 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface This text is designed for those who would become consultants in pediatric anesthe- sia. It is based on a curriculum developed since 1992 in our department to illustrate the breadth and depth of the practice of pediatric anesthesia. Weekly meetings are held with our fellows and many of our faculty who are or who have been associate examiners of the American Board of Anesthesiology. The program is an integral part of the didactic series in the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children’s Hospital. An ability to explain why various data are required before or during the care of a patient or why a certain anesthesia care plan was chosen was critical to us in our philosophy of the course, and we have tried to preserve that ideal during the crafting of this text. Although the interactive aspect of a dialog between examiner and exam- inee cannot be effectively recreated through a textbook, the reader is encouraged— strongly so—to use this book in creative ways to try to mimic the spontaneity achievable through conversation. First of all, a “buddy” system is advisable. Secondly, a small handheld recorder is extremely useful when using the questions as prompts; the contemplative reader will listen critically to the responses he or she has offered and then hopefully improve as the recording continues. Using material- ity as the best endpoint for adequate answers, the discerning reader should attempt to answer the question to the satisfaction of an imaginary partner—whether a par- ent, a surgeon, a pediatrician, or another anesthesiology colleague calling for help. With practice and introspection, it is amazing how similar, rather than different, the answers are to these diverse audiences. This third edition has the same purpose as our previous endeavors—to accom- pany the reader’s journey in attaining proficiency, expertise, and, finally, mastery in the consultative practice of pediatric anesthesiology. The formatting of the book is designed to encourage the reader’s free flow of ideas. One should begin with look- ing at both facing pages, then progress to covering the answers on the right side, and eventually cover the questions on the left. In this very simple, programmed text manner, practice at generating the appropriate breadth and depth of answers, and then questions, can be encouraged. v vi Preface The written examinations, seen at the beginning of the text as a baseline in pedi- atric medicine, are primarily knowledge-based, reflecting factual medical informa- tion necessary for the subspecialty practice of pediatric anesthesiology. With this basic guidance, the reader is encouraged to be creative throughout this book, to use imagination and a fund of knowledge in bringing yourself “into the operating room” and managing the patient in an expert fashion—one that would, in the eyes of peers as well as patients and their families, merit the awarding of “con- sultant in pediatric anesthesiology.” Boston, MA, USA Robert S. Holzman Boston, MA, USA Thomas J. Mancuso Boston, MA, USA Joseph P. Cravero Boston, MA, USA James A. DiNardo Contents Part I Pediatric Medicine for Pediatric Anesthesiologists 1 General Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Thomas J. Mancuso 2 Newborn Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Thomas J. Mancuso 3 Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Thomas J. Mancuso 4 Cardiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Thomas J. Mancuso 5 The Musculoskeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Thomas J. Mancuso 6 Hematology/Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Thomas J. Mancuso 7 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Thomas J. Mancuso Part II C onsultations in Pediatric Anesthesia 8 Prematurity/Extreme Prematurity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Thomas J. Mancuso 9 Newborn Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Thomas J. Mancuso 10 Fetal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Joseph P. Cravero and Thomas J. Mancuso vii viii Contents 11 Conjoined Twins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Joseph P. Cravero 12 Neuroanesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Thomas J. Mancuso 13 Orthopedics I: Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 Robert S. Holzman 14 Orthopedics II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Robert S. Holzman 15 Congenital Bone and Connective Tissue Disorders . . . . . . . . . . . . . . . 231 Robert S. Holzman and Joseph P. Cravero 16 Otolaryngology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 Robert S. Holzman 17 Craniofacial and Maxillofacial Surgery . . . . . . . . . . . . . . . . . . . . . . . . 259 Robert S. Holzman 18 Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 Robert S. Holzman 19 Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 Robert S. Holzman 20 Thoracic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 Robert S. Holzman 21 Cardiac I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 James A. DiNardo 22 Cardiac II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325 James A. DiNardo 23 Cardiac III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 James A. DiNardo 24 Cardiac IV: Mechanical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357 James A. DiNardo 25 Genitourinary Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Thomas J. Mancuso and Joseph P. Cravero 26 Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381 Thomas J. Mancuso 27 Minimally Invasive Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401 Robert S. Holzman 28 Ambulatory Surgery Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 Thomas J. Mancuso and Joseph P. Cravero Contents ix 29 Anesthesia Outside the Operating Room . . . . . . . . . . . . . . . . . . . . . . . 425 Robert S. Holzman 30 Vascular Anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435 Robert S. Holzman 31 Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445 Joseph P. Cravero 32 Trauma I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 459 Robert S. Holzman 33 Trauma II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471 Thomas J. Mancuso 34 Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489 Joseph P. Cravero and Robert S. Holzman 35 Behavioral Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501 Thomas J. Mancuso 36 Adolescence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513 Robert S. Holzman 37 Obesity and Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527 Robert S. Holzman 38 Gastrointestinal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543 Joseph P. Cravero and Thomas J. Mancuso 39 Renal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557 Joseph P. Cravero 40 Acid-Base Disturbances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569 Joseph P. Cravero 41 Skin Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 581 Robert S. Holzman 42 Allergy and Immunology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595 Robert S. Holzman 43 Inborn Errors of Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 607 Robert S. Holzman 44 Infectious Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621 Thomas J. Mancuso 45 Neuromuscular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 635 Joseph P. Cravero 46 Endocrinopathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651 Thomas J. Mancuso x Contents 47 Equipment and Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 667 Robert S. Holzman 48 Regional Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 685 Joseph P. Cravero 49 Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699 Joseph P. Cravero 50 Postanesthesia Care Unit (PACU) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715 Joseph P. Cravero 51 Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 737 Thomas J. Mancuso 52 Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761 Thomas J. Mancuso and Joseph P. Cravero Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 773
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