2012-09-06

Sepsis : Anaesthetics Management

There was a patient presenting to us for his source control procedure, he had an infected dry gangrene of his toe. He has diabetes, hypertension, end-staged renal disease and peripheral vascular disease, he receives regular haemodialysis for nearly two months now. His baseline creatinine was somewhere around 2 mg/dl, but after he developed congestive heart failure, respiratory failure requiring an ICU admission, his creatinine rose to 6 mg/dl, and has a double lumen catheter for regular haemodialysis.

When he was scheduled for toe amputation, he may also had the problem of hospital acquired pneumonia, the temperature in the prep area was 38.8C, the heart rate of more than 120/min, his blood pressure was quite all right, but he had oxygen saturation with room air at 93-95%. He appeared to be drowsy however he could respond to verbal command.

When he was at the operating theatre prep area, the nurse at the waiting area told you that he had just been dialysed and was sent from there.

What are your anaesthetic considerations for this man?

His anaesthetic management is just right here;


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