In the immediate post-operative period the common cause of respiratory insufficiency could be because of the following, except.
Correct Answer: Mild Hypovalemia
Description: Ans. is 'c' i.e. Mild hypovolemia The first two options are quite obvious causes of respiratory insufficiency (see the table at the end of this answer)The confusion is between Mild hypovolemia and myocardial infarctionAbout mild hypovolemiaBailey writes that "Healthy volunteers could have 10-15 percent of their blood volume removed with no significant change in heart rate, blood pressure, cardiac output or blood flow to the splanchnic bed",In mild hypovolemia, the systemic blood circulation is maintained by shifting the blood from splanchnic circulation to the systemic circulation.About Myocardial infarctionCSDT writes - "Approx. 0.4% of all pts undergoing an op. in USA develop post-operative MI. The incidence increases to 5 to 12%pts. undergoing operation for manifestation of atherosclerosis. Over half of postoperative MI are asymptomatic."The inference I could draw is -Even though MI has a very low post op. incidence it can cause respiratory insufficiency. Mild hypervolemia on the other hand is well compensated by body and remains asymptomatic, thus I am in favour of mild hypovolemia.Causes of hypoventilation after surgery and anesthesiaCentral respiratory depressionOpioids (overdose)Inhalational and intravenous anesthesiaCNS pathologyPoor respiratory muscle functionResidual Neuromuscular blockerNeuromuscular diseaseDiaphragmatic impairment (upper abdominal surgery)Obesity, abdominal distension abdominal binders.Airway obstruction, bronchospasmPneumothorax, hemothoraxChronic and acute lung diseaseHigh CO2 production.
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now