Internal Medicine

P1: SBT

0521779407-04a CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:48

Atelectasis Atherosclerotic Occlusive Disease 179

Endotracheal intubation: terminal prognosis with advance

directives

follow-up

During Treatment

■Titrate pressure support levels in increments of 5 cm H 2 O to achieve

visible chest wall expansion

■Wean FiO2 and pressure support to keep SpO 2 >90% or PaO >60 mm

Hg

■Treat bronchospasm with albuterol aerosol

Routine

■Serial CXRs

■Sedation as needed with narcotics and benzodiazepines for agitation

■Track progress with serial tidal volume and vital capacity measure-

ments

complications and prognosis

■Respiratory failure

Atherosclerotic Occlusive Disease........................

RAJABRATA SARKAR, MD

history & physical

History

■Risk factors for atherosclerosis

➣Smoking (present in >90% of patients)

➣Hypertension

➣Hyperlipidemia

➣Hypercoaguable state (suspect in patients<50 years of age)

➣Diabetes

■Most have symptoms of atherosclerosis in another vascular bed

(coronary, cerebrovascular, etc.)

Signs & Symptoms

■Cerebrovascular

➣Acute stroke

➣transient ischemic attacks (TIA)

transient monocular blindness

amourosis fugax – “curtain coming down partway across one

eye”