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Stoelting’s
ANESTHESIA
AND
CO-EXISTING
DISEASE
Stoelting’s
ANESTHESIA
AND
CO-EXISTING
DISEASE
Roberta L. Hines, MD
Nicholas M. Greene Professor and Chairman
Department of Anesthesiology
Yale University School of Medicine
Chief of Anesthesiology
Yale-New Haven Hospital
New Haven, Connecticut
Katherine E. Marschall, MD, LLD (honoris causa)
Anesthesiologist–retired
New Haven, Connecticut
Seventh Edition
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
STOELTING’S ANESTHESIA AND CO-EXISTING
DISEASE, SEVENTH EDITION ISBN: 978-0-323-40137-1
Copyright © 2018 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechani-
cal, including photocopying, recording, or any information storage and retrieval system, without permission in
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sions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright
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This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
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With respect to any drug or pharmaceutical products identified, readers are advised to check the most
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otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
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Previous editions copyrighted 2012, 2008, 2002, 1993, 1988, 1983.
Library of Congress Cataloging-in-Publication Data
Names: Hines, Roberta L., editor. | Marschall, Katherine E., editor.
Title: Stoelting’s anesthesia and co-existing disease / edited by Roberta L.
Hines, Katherine E. Marschall.
Other titles: Anesthesia and co-existing disease
Description: Seventh edition. | Philadelphia, PA : Elsevier, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017000203 | ISBN 9780323401371 (hardcover : alk. paper)
Subjects: | MESH: Anesthesia--adverse effects | Anesthesia--methods |
Comorbidity | Anesthetics--adverse effects | Intraoperative Complications
Classification: LCC RD82.5 | NLM WO 245 | DDC 617.9/6041--dc23
LC record available at https://lccn.loc.gov/2017000203
Executive Content Strategist: Dolores Meloni
Content Development Manager: Lucia Gunzel
Publishing Services Manager: Catherine Jackson
Senior Project Manager: Daniel Fitzgerald
Designer: Paula Catalano
Printed in China.
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Preface
In 1983 the first edition of Anesthesia and Co-Existing Disease care medicine. The chapters on geriatric medicine and cancer
by Drs. Robert K. Stoelting and Stephen F. Dierdorf was pub- medicine have major updates, but all chapters contain new
lished with the stated goal “to provide a concise description information, refer to major medical society guidelines and
of the pathophysiology of disease states and their medical recommendations that affect the practice of perioperative
management that is relevant to the care of the patient in the medicine, and contain many tables, figures, illustrations, and
perioperative period.” Since then, five more editions have been photographs to aid in understanding key concepts. We hope
published. The last two editions were published under our edi- that our readers will continue to find this book relevant to the
torial leadership. care of the patient in the perioperative period.
This seventh edition of Anesthesia and Co-Existing Disease
continues the tradition of presenting new and updated medi- Roberta L. Hines, MD
cal information to the anesthesiology community. New chap- Katherine E. Marschall, MD
ters include those on sleep-disordered breathing and critical
v
Contributors
Shamsuddin Akhtar, MBBS Michelle W. Diu, MD
Associate Professor of Anesthesiology Department of Anesthesiology
Yale University School of Medicine Children’s Hospital and Medical Center
New Haven, Connecticut Assistant Professor of Anesthesiology
Chapter 5: Ischemic Heart Disease University of Nebraska College of Medicine
Chapter 16: Diseases of Aging Omaha, Nebraska
Chapter 30: Pediatric Diseases
Ferne Braveman, MD
Professor of Anesthesiology and of Obstetrics, Manuel Fontes, MD
Gynecology and Reproductive Sciences Professor of Anesthesiology and Critical Care
Division Chief Medicine
Anesthesiology Yale University School of Medicine
Vice Chair Administrative Affairs New Haven, Connecticut
Director, Obstetrics & Gynecology Anesthesiology Chapter 9: Systemic and Pulmonary
Yale University School of Medicine Arterial Hypertension
New Haven, Connecticut
Chapter 31: Pregnancy-Associated Diseases Loreta Grecu, MD
Associate Professor of Anesthesiology
Tricia Brentjens, MD University of New York at Stony Brook
Associate Professor of Anesthesiology New York, New York
Columbia University Medical Center Chapter 12: Vascular Disease
New York, New York
Chapter 17: Diseases of the Liver and Biliary Tract Paul M. Heerdt, MD, PhD
Professor of Anesthesiology
Jean G. Charchaflieh, MD, MPH, DrPH Yale University School of Medicine
Associate Professor of Anesthesiology New Haven, Connecticut
Yale University School of Medicine Chapter 9: Systemic and Pulmonary
New Haven, Connecticut Arterial Hypertension
Chapter 1: Sleep-Related Breathing Disorders
Antonio Hernandez Conte, MD, MBA
Nikhil Chawla, MBBS Associate Professor of Anesthesiology
Assistant Professor of Anesthesiology Cedars-Sinai Medical Center
Yale University School of Medicine Los Angeles, California
New Haven, Connecticut Chapter 26: Infectious Diseases
Chapter 12: Vascular Disease
Adriana Herrera, MD
Ranjit Deshpande, MD, BS Assistant Professor of Anesthesiology
Assistant Professor of Anesthesiology Yale University School of Medicine
Yale University School of Medicine New Haven, Connecticut
Director, Liver Transplant Anesthesiology Chapter 6: Valvular Heart Disease
Yale-New Haven Hospital
New Haven, Connecticut
Chapter 3: Restrictive Respiratory
Diseases and Lung Transplantation
vii
viii CONTRIBUTORS
Roberta L. Hines, MD Thomas J. Mancuso, MD
Nicholas M. Greene Professor and Chairman Senior Associate in Anesthesiology
Department of Anesthesiology Boston Children’s Hospital
Yale University School of Medicine Associate Professor of Anesthesiology
Chief of Anesthesiology Harvard Medical School
Yale-New Haven Hospital Boston, Massachusetts
New Haven, Connecticut Chapter 30: Pediatric Diseases
Chapter 29: Psychiatric Disease,
Substance Abuse, and Drug Overdose Luiz Maracaja, MD
Assistant Professor of Anesthesiology
Natalie F. Holt, MD, MPH University of Texas Health Science Center in San Antonio
Assistant Professor of Anesthesiology San Antonio, Texas
Yale University School of Medicine Chapter 11: Pericardial Disease and Cardiac Trauma
New Haven, Connecticut
Associate Director of Anesthesiology Katherine E. Marschall, MD, LLD (honoris causa)
VA Connecticut Healthcare System Anesthesiologist–retired
West Haven, Connecticut New Haven, Connecticut
Chapter 22: Renal Disease Chapter 25: Skin and Musculoskeletal Diseases
Chapter 27: Diseases Related to Immune System Dysfunction Chapter 29: Psychiatric Disease, Substance Abuse, and Drug
Chapter 28: Cancer Overdose
Viji Kurup, MBBS Veronica Matei, MD
Associate Professor of Anesthesiology Assistant Professor of Anesthesiology
Yale University School of Medicine Yale University School of Medicine
New Haven, Connecticut New Haven, Connecticut
Chapter 2: Obstructive Respiratory Diseases Chapter 20: Nutritional Diseases:
Chapter 3: Restrictive Respiratory Diseases and Lung Obesity and Malnutrition
Transplantation
Bryan G. Maxwell, MD, MPH
William L. Lanier, Jr., MD Anesthesiologist
Professor of Anesthesiology Randall Children’s Hospital
Mayo Clinic Portland, Oregon
Rochester, Minnesota Chapter 7: Congenital Heart Disease
Chapter 13: Diseases Affecting the Brain
Chapter 14: Spinal Cord Disorders Raj K. Modak, MD
Chapter 15: Diseases of the Autonomic and Peripheral Associate Professor
Nervous Systems Director of Cardiac Anesthesia
Henry Ford Medical Group
Linda L. Maerz, MD Henry Ford Hospital
Associate Professor of Surgery and Anesthesiology Detroit, Michigan
Yale University School of Medicine Chapter 11: Pericardial Disease and Cardiac Trauma
New Haven, Connecticut
Chapter 4: Critical Illness Tori Myslajek, MD
Assistant Professor of Anesthesiology
Adnan Malik, MD Yale University School of Medicine
Assistant Professor of Anesthesiology New Haven, Connecticut
Yale University School of Medicine Chapter 18: Diseases of the Gastrointestinal System
New Haven, Connecticut
Chapter 10: Heart Failure and Cardiomyopathies
CONTRIBUTORS ix
Adriana D. Oprea, MD Hossam Tantawy, MBChB
Assistant Professor of Anesthesiology Assistant Professor of Anesthesiology and Trauma Surgery
Yale University School of Medicine Yale University School of Medicine
New Haven, Connecticut New Haven, Connecticut
Chapter 24: Hematologic Disorders Chapter 18: Diseases of the Gastrointestinal System
Chapter 19: Inborn Errors of Metabolism
Jeffrey J. Pasternak, MS, MD
Associate Professor of Anesthesiology Jing Tao, MD
Mayo Clinic Assistant Professor of Anesthesiology
Rochester, Minnesota Yale University School of Medicine
Chapter 13: Diseases Affecting the Brain New Haven, Connecticut
Chapter 14: Spinal Cord Disorders Chapter 2: Obstructive Respiratory Diseases
Chapter 15: Diseases of the Autonomic and Peripheral Chapter 19: Inborn Errors of Metabolism
Nervous Systems
Russell T. Wall, III, MD
Wanda M. Popescu, MD Chair, Department of Anesthesiology and
Associate Professor of Anesthesiology Perioperative Care
Yale University School of Medicine MedStar Georgetown University Hospital
New Haven, Connecticut Professor of Anesthesiology and Pharmacology
Chapter 10: Heart Failure and Cardiomyopathies Georgetown University School of Medicine
Chapter 20: Nutritional Diseases: Obesity and Malnutrition Washington, DC
Chapter 23: Endocrine Disease
Stanley H. Rosenbaum, MA, MD
Professor of Anesthesiology, Internal Zachary Walton, MD, PhD
Medicine & Surgery Attending Anesthesiologist
Yale University School of Medicine Anesthesia Associates of Willimantic, CT
New Haven, Connecticut Willimantic, Connecticut
Chapter 4: Critical Illness Chapter 31: Pregnancy-Associated Diseases
Robert B. Schonberger, MD, MA Kelley Teed Watson, MD
Assistant Professor of Anesthesiology Anesthesiologist
Yale University School of Medicine Anesthesiology of Greenwood, Inc.
New Haven, Connecticut Greenwood, South Carolina
Chapter 21: Fluid, Electrolyte, and Acid-Base Disorders Chapter 8: Abnormalities of Cardiac Conduction and
Cardiac Rhythm
Denis Snegovskikh, MD
Attending Anesthesiologist Christopher A.J. Webb, MD
Anesthesia Associates of Willimantic, CT Assistant Professor of Anesthesiology
Willimantic, Connecticut Columbia University Medical Center
Chapter 31: Pregnancy-Associated Diseases New York, New York
Chapter 17: Diseases of the Liver and Biliary Tract
Jochen Steppan, MD, DESA
Assistant Professor of Anesthesiology and Paul David Weyker, MD
Critical Care Medicine Assistant Professor of Anesthesiology
Johns Hopkins University School of Medicine Columbia University Medical Center
Baltimore, Maryland New York, New York
Chapter 7: Congenital Heart Disease Chapter 17: Diseases of the Liver and Biliary Tract
Contents
1 Sleep-Related Breathing Disorders 1 17 Diseases of the Liver and Biliary Tract 345
Jean G. Charchaflieh Tricia Brentjens, Paul David Weyker,
2 Obstructive Respiratory Diseases 15 Christopher A.J. Webb
Jing Tao, Viji Kurup 18 Diseases of the Gastrointestinal System 359
3 Restrictive Respiratory Diseases and Lung Hossam Tantawy, Tori Myslajek
Transplantation 33 19 Inborn Errors of Metabolism 377
Ranjit Deshpande, Viji Kurup Hossam Tantawy, Jing Tao
4 Critical Illness 53 20 Nutritional Diseases: Obesity and
Linda L. Maerz, Stanley H. Rosenbaum Malnutrition 385
5 Ischemic Heart Disease 79 Veronica Matei, Wanda M. Popescu
Shamsuddin Akhtar 21 Fluid, Electrolyte, and Acid-Base Disorders 407
6 Valvular Heart Disease 107 Robert B. Schonberger
Adriana Herrera 22 Renal Disease 425
7 Congenital Heart Disease 129 Natalie F. Holt
Jochen Steppan, Bryan G. Maxwell 23 Endocrine Disease 449
8 Abnormalities of Cardiac Conduction and Russell T. Wall, III
Cardiac Rhythm 151 24 Hematologic Disorders 477
Kelley Teed Watson Adriana D. Oprea
9 Systemic and Pulmonary Arterial 25 Skin and Musculoskeletal Diseases 507
Hypertension 183
Katherine E. Marschall
Manuel Fontes, Paul M. Heerdt
26 Infectious Diseases 539
10 Heart Failure and Cardiomyopathies 199
Antonio Hernandez Conte
Wanda M. Popescu, Adnan Malik
27 Diseases Related to Immune System
11 Pericardial Disease and Cardiac Trauma 225 Dysfunction 567
Raj K. Modak, Luiz Maracaja Natalie F. Holt
12 Vascular Disease 237 28 Cancer 585
Loreta Grecu, Nikhil Chawla Natalie F. Holt
13 Diseases Affecting the Brain 265 29 Psychiatric Disease, Substance Abuse, and
Jeffrey J. Pasternak, William L. Lanier, Jr. Drug Overdose 611
14 Spinal Cord Disorders 305 Katherine E. Marschall, Roberta L. Hines
Jeffrey J. Pasternak, William L. Lanier, Jr. 30 Pediatric Diseases 635
15 Diseases of the Autonomic and Peripheral Michelle W. Diu, Thomas J. Mancuso
Nervous Systems 315 31 Pregnancy-Associated Diseases 671
Jeffrey J. Pasternak, William L. Lanier, Jr. Zachary Walton, Denis Snegovskikh,
16 Diseases of Aging 327 Ferne Braveman
Shamsuddin Akhtar Index 695
xi
