Basic Surgery MCQ Answer 007

Answer: BD



DISCUSSION:

Many different monitoring techniques may be used to assess the adequacy of therapy for shock. The pulmonary artery catheter can provide important hemodynamic and oxygen transport data that are very useful in directing therapy aimed at optimizing cardiac function and oxygen delivery. Pulmonary artery and pulmonary capillary wedge pressure readings should be made at end-expiration to minimize ventilatory artifacts. Continuous SvO 2 monitoring, an accurate, reliable method that combines pulmonary artery catheterization with the technique of reflectance spectrophotometry, may provide early warning signs of hemodynamic compromise or inadequate oxygen delivery. Gastrointestinal tonometry provides information that allows one to infer the adequacy of splanchnic tissue perfusion. In this technique, intramucosal pH is calculated using the Henderson-Hasselbalch equation and measurements of gut intraluminal PCO 2 and arterial bicarbonate concentration. Serum lactate concentration may be monitored in shock to detect metabolic acidosis associated with anaerobic metabolism; however, mild to moderate hyperlactatemia may also be seen with liver disease, toxin ingestion, and hypermetabolic states not associated with shock.

Category: Surgery MCQs