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EDITION 4
Lee A. Fleisher, MD
Robert D. Dripps Professor and Chair of
Anesthesiology and Critical Care Medicine
Professor of Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania
Michael F. Roizen, MD
Roizen Family Chair
Wellness Institute
Professor of Anesthesiology
Chief Wellness Officer
The Cleveland Clinic
Cleveland, Ohio
Jeffrey D. Roizen, MD, PhD

Assistant Professor of Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Division of Endocrinology and Diabetes
The Children’s Hospital of Philadelphia
@ejournals
Contributors
Vincent S. Cowell, MD D’andra J. Davis, MD Onur Demirci, MD

Associate Professor, Anesthesiology Assistant Professor Assistant Professor of Anesthesiology
Temple University Health System Department of Anesthesiology Department of Anesthesiology and Perioperative
Philadelphia, Pennsylvania Louisiana State University School of Medicine Medicine
Cancer, Breast New Orleans, Louisiana Mayo Clinic
Hemophilia Tetracyclines Rochester, Minnesota
Aspiration, Perioperative
Paula A. Craigo, MD Jeffrey D. Davis, MD Sarcoma
Consultant, Anesthesiology and Perioperative Resident Physician
Medicine Department of Anesthesiology and Critical Care Ranjit Deshpande, MBBS
Mayo Clinic Medicine Assistant Professor of Anesthesiology
Rochester, Minnesota Oregon Health and Science University Director of Transplant Anesthesiology
Aspiration, Perioperative Portland, Oregon Yale School of Medicine
Pulmonary Hypertension Yale New Haven Hospital
Efrain I. Cubillo, MD New Haven, Connecticut
Pain Medicine Fellow Peter J. Davis, MD Carcinoid Syndrome
Diabetes, Type II (Noninsulin-Dependent)
Department of Anesthesia and Pain Dr. Joseph H. Marcy Endowed Chair in Pediatric
Beth Israel Deaconess Medical Center Anesthesia
Boston, Massachusetts Professor of Anesthesia and Pediatrics Dawn P. Desiderio, MD
Herniated Nucleus Pulposus University of Pittsburgh School of Medicine Vice Chair
Anesthesiologist-in Chief Department of Anesthesiology and Critical Care
Christopher J. Cullom, MD Children’s Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania
Medicine
Memorial Sloan Kettering Cancer Center
Resident Physician
Tulane University Wilms Tumor New York, New York
Department of Anesthesia Cancer, Esophageal
New Orleans, Louisiana Sara K. Davis, CRNA
Alagille Syndrome Instructor Tricia Desvarieux, MD
Antipsychotics Anesthesiology and Perioperative Medicine Assistant Professor of Anesthesiology and Critical
Blue Cohosh (Caulophyllum thalictroides) Oregon Health and Sciences University Care
Bulimia Nervosa Portland, Oregon Department of Anesthesiology
Cranberry Wolff-Parkinson-White Syndrome George Washington University School of Medicine
Ehlers-Danlos Syndrome and Health Sciences
CONTRIBUTORS
Gout
Schizophrenia
Bracken J. De Witt, MD, PhD Washington, District of Columbia
Chagas Disease
Assistant Professor
Wegener Granulomatosis (Granulomatosis With Department of Anesthesia
Polyangiitis) Louisiana State University Health Sciences Center Sarah Deverman, MD
New Orleans, Louisiana Assistant Professor, Pediatric Anesthesiology
Craig E. Cummings, MD Ephedra (Ma-Huang) Department of Anesthesiology and Perioperative
Assistant Professor of Anesthesiology Medicine
Medical College of Wisconsin
Clement J. Zablocki Veterans Affairs Medical Center
Stacie Deiner, MS, MD Oregon Health and Sciences University
Portland, Oregon
Associate Professor of Anesthesia, Neurosurgery,
Milwaukee, Wisconsin Tetralogy of Fallot
Geriatrics and Palliative Care
Familial Dysautonomia (Riley-Day Syndrome) Icahn School of Medicine at Mount Sinai
New York, New York Pascale Dewachter, MD, PhD
Chris J. Curatolo, MD, MEM Parkinson Disease (Paralysis Agitans) Anesthesiologist
Fellow, Division of Pain Management Service d’Anesthésie-Réanimation
Department of Anesthesiology, Perioperative and Pain
Medicine
Francina Del Pino, MD Groupe Hospitalier de Paris-Seine-Saint-Denis
Assistance Publique-Hôpitaux de Paris and INSERM
Fellow, Pediatric Anesthesiology
The Mount Sinai Hospital UMR-S970, Sorbonne Paris Cité
UPMC Children’s Hospital of Pittsburgh
Icahn School of Medicine at Mount Sinai Paris, France
New York, New York Mastocytosis
Craniosynostosis
Naltrexone
Paul J. Delahoussaye, MD Ketan Dhatariya, MBBS, MSc, MD,

Pikulkaew Dachsangvorn, MD Anesthesiology Resident MS, FRCP
Assistant Professor of Pediatric Anesthesiology Consultant in Diabetes and Endocrinology
Department of Anesthesia
Oregon Health and Science University Elsie Bertram Diabetes Centre
Louisiana State University Health Sciences Center
Portland, Oregon Norfolk and Norwich University Hospitals NHS
New Orleans, Louisiana
Becker Disease Foundation Trust
Myotonia Dystrophica (Myotonic Dystrophy, Steinert
CHARGE Association Norwich, United Kingdom
Disease)
Metformin (Glucophage)
William H. Daily, MD Ellise Delphin, MD Oral Hypoglycemic Agents
Assistant Professor Chair and Professor of Anesthesiology
Department of Anesthesiology Albert Einstein College of Medicine Christian Diez, MD, MBA
University of Texas Health Science Center Associate Professor and Vice Chair of Clinical Affairs
Montefiore Medical Center
Houston, Texas University of Miami Miller School of Medicine
New York, New York
Hypophosphatemia Miami, Florida
Antithrombin III Deficiency
Burn Injury, Electrical
Ahmed M. Darwish, MD Carotid Sinus Syndrome
Associate Professor of Anesthesiology and Surgery Encephalopathy, Hypertensive
Keck School of Medicine
University of Southern California
Los Angeles, California
Lyme Disease
xi
Contributors
M. Veronica Dioverti, MD Thomas J. Ebert, MD, PhD Jonathan P. Eskander, MD, MBA
Instructor in Medicine Professor of Anesthesiology Resident
Department of Infectious Diseases Department of Anesthesiology Department of Anesthesiology
Mayo Clinic Medical College of Wisconsin Tulane/LSU Health
Rochester, Minnesota Clement J. Zablocki Veterans Affairs Medical Center New Orleans, Louisiana
Cytomegalovirus Infection Milwaukee, Wisconsin Gingko biloba
Familial Dysautonomia (Riley-Day Syndrome)
Jeffrey B. Dobyns, DO Nauder Faraday, MD MPH
Assistant Professor of Anesthesiology and Matthias Eikermann, MD, PhD Professor, Anesthesiology/Critical Care Medicine,
Perioperative Medicine Clinical Director Surgery, and Medicine
University of Alabama at Birmingham School of Department of Anesthesia, Critical Care, and Pain Johns Hopkins University School of Medicine
Medicine Medicine Baltimore, Maryland
Birmingham, Alabama Massachusetts General Hospital Thrombocytopenia
Hepatitis, Halothane Boston, Massachusetts
Swallowing Disorders Sarah C. Fausel, BA
Karen B. Domino, MD, MPH Medical Student
Professor and Vice Chair for Clinical Research Seth Eisdorfer, MD School of Medicine
Department of Anesthesiology and Pain Medicine Assistant Professor Oregon Health and Science University
University of Washington School of Medicine Department of Anesthesiology Portland, Oregon
Seattle, Washington University of Colorado School of Medicine Anemia, Hemolytic
Silicosis Section of Pediatric Anesthesiology Central Neurogenic Hyperventilation
Children’s Hospital Colorado
Andra E. Duncan, MD, MS Aurora, Colorado
Gonorrhea
William J. Fawcett, FRCA,
Assistant Professor FFPMRCA
Department of Cardiothoracic Anesthesiology Consultant in Anaesthesia and Pain Medicine
Cleveland Clinic Lerner College of Medicine Karim El Harchaoui, MD, PhD Department of Anaesthetics
Cleveland, Ohio Department of Anesthesiology Royal Surrey County Hospital
Cardiomyopathy, Restrictive Gelre Hospital Apeldoorn Guildford, United Kingdom
Apeldoorn, The Netherlands Honorary Senior Lecturer
Lauren K. Dunn, MD, PhD Spinal Muscular Atrophy University College London
Assistant Professor London, United Kingdom
Amir Elhassan, MD
CONTRIBUTORS
University of Virginia Acetaminophen

Charlottesville, Virginia Assistant Professor
Pituitary Tumors Department of Anesthesiology Michael Feduska, MD
Louisiana State University Health Sciences Center Assistant Professor of Clinical Anesthesiology and
Silvia Duong, BScPhm, PharmD New Orleans, Louisiana
Hepatitis, Alcoholic
Critical Care
Assistant Professor Department of Anesthesiology and Critical Care
Myotonia Dystrophica (Myotonic Dystrophy, Steinert Hospital of the University of Pennsylvania
Jewish General Hospital, Herzl Family Medicine
Disease) Philadelphia, Pennsylvania
Center
Tetracyclines Inhaled Bronchodilators
Department of Family Medicine
McGill University
Montreal, Canada Nabil M. Elkassabany, MD, MSCE James J. Fehr, MD
Bisphosphonates Assistant Professor Professor of Pediatric Anesthesiology and Critical Care
Department of Anesthesiology and Critical Care Washington University School of Medicine
Frank W. Dupont, MD Perelman School of Medicine at the University of
Pennsylvania
St. Louis, Missouri
Assistant Professor of Anesthesia and Critical Care Mucopolysaccharidoses
Department of Anesthesia and Critical Care
Delirium (Postanesthetic)/Dementia
University of Chicago Medicine Jared Feinman, MD
Chicago, Illinois Assistant Professor
Dilated Cardiomyopathy Anila B. Elliott, MD Department of Anesthesiology and Critical Care
Epsilon-Aminocaproic Acid (Amicar) Resident Hospital of the University of Pennsylvania
Department of Anesthesiology and Perioperative Philadelphia, Pennsylvania
L. Jane Easdown, MD, MHPE Medicine
Oregon Health and Science University
Aortic Stenosis
Associate Professor
Portland, Oregon
Department of Anesthesiology
Heart Disease, Congenital Laura H. Ferguson, MD
Vanderbilt University Medical Center Assistant Clinical Professor
Nashville, Tennessee Department of Anesthesiology
Cerebral Arteriovenous Malformations Matthew B. Ellison, MD University of Pittsburgh Medical Center St. Margaret
Trigeminal Neuralgia (Tic Doloureux) Associate Professor Pittsburgh, Pennsylvania
Department of Anesthesiology Glaucoma, Open-Angle
R. Blaine Easley, MD West Virginia University School of Medicine
Morgantown, West Virginia
Assistant Professor
Rifampin Ana Fernandez-Bustamante, MD,
Department of Anesthesiology and Critical Care
Medicine
PhD
Associate Professor
Johns Hopkins Hospital Hamdy Elsayed-Awad, MD Department of Anesthesiology
Baltimore, Maryland Associate Professor University of Colorado School of Medicine
Creatinine Department of Anesthesiology Aurora, Colorado
Licorice (Glycyrrhiza glabra) The Ohio State University Hypoxemia
Wexner Medical Center
Columbus, Ohio
Acute Intermittent Porphyria
xii
Contributors
Rohesh J. Fernando, MD Glucose-6-Phosphate Dehydrogenase Deficiency

Goodpasture Syndrome
Alexander Fort, MD
Assistant Professor of Anesthesiology Fellow, Critical Care Medicine
Wake Forest University School of Medicine Hashimoto Thyroiditis Department of Anesthesiology and Critical Care
Winston-Salem, North Carolina Hepatitis, Viral Medicine
Fabry Disease Hereditary Hemorrhagic Telangiectasia (Osler-Weber- Hospital of the University of Pennsylvania
Rendu Disease) Philadelphia, Pennsylvania
Hypertension
Marla B. Ferschl, MD Hypophosphatemia
Noonan Syndrome
Associate Professor of Clinical Anesthesia Juvenile Gaucher Disease (Type III/Subacute
Division of Pediatric Anesthesia Neuronopathic) Patrick J. Forte, MD
Department of Anesthesia and Perioperative Care Klippel-Feil Syndrome Associate Professor
University of California, San Francisco Leukotriene Antagonists Department of Anesthesiology
San Francisco, California Liddle Syndrome University of Pittsburgh
Myelomeningocele Long QT Syndrome Pittsburgh, Pennsylvania
Monoamine Oxidase Inhibitors; Reversible Inhibitors of Ulcerative Colitis, Chronic
John Fiadjoe, MD Monoamine Oxidase
Assistant Professor Myasthenia Gravis Caroline D. Fosnot, DO, MS
Department of Anesthesiology and Critical Care Neuroleptic Malignant Syndrome Assistant Professor
Medicine Nitroglycerin Department of Anesthesiology and Critical Care
Children’s Hospital of Philadelphia Noonan Syndrome Perelman School of Medicine at the University of
Hospital of the University of Pennsylvania Osteoporosis Pennsylvania
Philadelphia, Pennsylvania Paget Disease Philadelphia, Pennsylvania
Craniofacial Clefts Papillomatosis Otitis Media
Phenytoin
Phytosterols
R. Ryan Field, MD Polymyositis Charles Fox III, MD
Assistant Clinical Professor Pompe Disease Professor and Chair
Department of Anesthesiology and Perioperative Care Postoperative Encephalopathy, Metabolic Department of Anesthesiology
University of California Irvine Health Pseudoephedrine Louisiana State University Health
Orange, California Pyridostigmine Bromide University Hospitals
Neurofibromatosis Renal Failure, Chronic Shreveport, Louisiana
Rett Syndrome Amyotrophic Lateral Sclerosis
Aaron M. Fields, MD Reye Syndrome Galactosemia
CONTRIBUTORS
San Antonio, Texas Rheumatoid Arthritis
Pickwickian Syndrome Scleroderma Steven M. Frank, MD
Selective Estrogen Receptor Modulators Associate Professor
Smallpox
Gordon N. Finlayson, BSc, MD, Spasmodic Torticollis
Medicine
FRCP Spinal Cord Injury Johns Hopkins Medical Institutions
Cardiothoracic Anesthesiologist and Intensivist Sildenafil Citrate Baltimore, Maryland
Department of Anesthesiology St. John’s Wort (Hypercium perforatum) Anemia, Megaloblastic
University of British Columbia Stevens-Johnson Syndrome Polycythemia Vera
Vancouver General Hospital Subphrenic Abscess
Vancouver, Canada Supraventricular Tachycardia (Tachyarrhythmias)
Guillain-Barré Syndrome Syndrome X Geoff Frawley, MBBS, FANZCA
Tacrolimus (FK-506) Anaesthetist
Department of Anaesthesia and Pain Management
Gregory W. Fischer, MD Upper Respiratory Infections
Royal Children’s Hospital
Professor and Chairman Urinary Lithiasis
Urticaria, Cold Anaesthesia and Pain Management Research Group
Department of Anesthesiology and Critical Care Murdoch Children’s Research Institute
Medicine Valerian (Valeriana officinalis)
Varicella-Zoster Virus Clinical Associate Professor
Memorial Sloan Kettering Cancer Center Department of Paediatrics
New York, New York Warfarin (Coumadin)
Melbourne University
Ventricular Septal Rupture (Defect), Postmyocardial Melbourne, Australia
Infarction Melinda L. Fleming, MD, FRCPC Crouzon Syndrome
Program Director
Lee A. Fleisher, MD Postgraduate Anesthesiology Residency Program
Julie K. Freed, MD, PhD
Robert D. Dripps Professor and Chair of Assistant Professor
Departments of Anesthesiology and Perioperative Anesthesiologist
Anesthesiology and Critical Care Adult Cardiothoracic
Perelman School of Medicine at the University of Medicine and Pediatrics
Queen’s University Medical College of Wisconsin
Pennsylvania Milwaukee, Wisconsin
Philadelphia, Pennsylvania Kingston, Canada
Tracheoesophageal Fistula (Congenital) Endocardial Cushion Defect (Atrioventricular Canal)
Addison Disease
Angina, Chronic Stable
ACE Inhibitors Ronda R. Flower, MD Lewis Fry, MBBS, BMedSci
Antianxiety Medications Assistant Professor of Clinical Anesthesia (Student)
Aspirin (Acetylsalicyclic Acid) Department of Anesthesiology Medical Student
Autoimmune Diseases, Cold Louisiana State University School of Medicine Monash University
Beckwith-Widemann Syndrome New Orleans, Louisiana Melbourne, Australia
Bernard-Soulier Syndrome Bulimia Nervosa Substance Abuse Disorder (Perioperative)
Carpenter Syndrome (Acrocephalopolysyndactyly Type II)
Chagas Disease
Chromium David N. Flynn, MD, MBA Robert A. Fry, MBChB, FANZCA
Resident of Anesthesiology Consultant Anaesthetist
Creatinine
Department of Anesthesiology Auckland City Hospital
Cromolyn Sodium
University of Pennsylvania Auckland, New Zealand
Dandy-Walker Syndrome
Philadelphia, Pennsylvania Substance Abuse Disorder (Perioperative)
Deep Vein Thrombosis
Friedreich Ataxia Hypoparathyroidism
xiii
Contributors
William R. Furman, MD, MMHC Chris Giordano, MD Taras Grosh, MD

Vice President, Regional Perioperative Service Line Associate Professor of Anesthesiology Pain Medicine Fellow
Dartmouth Hitchcock Medical Center University of Florida Baystate Medical Center
Lebanon, New Hampshire Gainesville, Florida Springfield, Massachusetts
Interim Chair Diuretics Myoclonic Epilepsy With Ragged Red Fibers
Department of Anesthesiology Valproate
Darthmouth Geisel School of Medicine Sharmil S. Gohil, MD
Hanover, New Hampshire
Emphysema
Resident Physician Anurag Gupta, DA, DNB, DESA
Department of Anesthesiology and Critical Care Associate Consultant, Anaesthesiology
Hospital of the University of Pennsylvania VPS Rockland Hospital, Qutub
Elizabeth Mahanna Gabrielli, MD Philadelphia, Pennsylvania New Delhi, India
Clinical Associate Vitamin B12/Folate Deficiency Behçet Disease
Medicine
Perelman School of Medicine at the University of
Hernando Gomez, MD, MPH Arun K. Gupta, MBBS, MD,
Pennsylvania
Assistant Professor of Critical Care Medicine, FIRAPM, FICCM
Emergency Medicine and Clinical and Translational Consultant in Anaesthesia
Philadelphia, Pennsylvania Science Department of Critical Care Medicine Raja Hospital NWSR
Intracranial Hypertension Center for Critical Care Nephrology, Cardiopulmonary Punjab, India
Physiology Laboratory, CRISMA, and the Vascular Scheie Syndrome (Mucopolysaccharidosis Type IS)
Zoe S. Gan, BA Medicine Institute
Medical Student University of Pittsburgh Medical Center
University of North Carolina School of Medicine Pittsburgh, Pennsylvania Kathryn C. Hall, MD
Chapel Hill, North Carolina Necrotizing Fasciitis Instructor of Anesthesiology
Nonsteroidal Anti-Inflammatory Drugs Department of Anesthesiology and Critical Care
Hospital of the University of Pennsylvania
Alanna E. Goodman, MD Philadelphia, Pennsylvania
Jonathan Gavrin, MD Anesthesiologist Leukotriene Antagonists
Clinical Professor Providence Medical Center
Department of Anesthesiology and Critical Care Everett, Washington
Hospital of the University of Pennsylvania Do Not Resuscitate Orders Michael A. Hall, MD
Philadelphia, Pennsylvania Instructor of Anesthesiology
Gold (Auranofin, Aurothioglucose, Aurothiomalate) Stephanie R. Goodman, MD Hospital of the University of Pennsylvania
CONTRIBUTORS
Professor of Anesthesiology at CUMC Philadelphia, Pennsylvania

Steven Gayer, MD, MBA Department of Anesthesiology Goodpasture Syndrome
Professor of Anesthesiology and Ophthalmology Columbia University Leukotriene Antagonists
Miller School of Medicine New York, New York Portal Hypertension
University of Miami Pregnancy, Maternal Physiology
Miami, Florida
N. James Halliday, MB, ChB,
Glaucoma, Closed-Angle Ori Gottlieb, MD FCA(I)
Associate Professor Professor of Clinical Anesthesiology
Julie Gayle, MD Department of Anesthesia and Critical Care Associate Departments of Anesthesiology, Perioperative
Assistant Professor Chief Medical Information Officer Medicine and Pain Management
Department of Anesthesiology University of Chicago University of Miami
Louisiana State University School of Medicine Chicago, Illinois Miami, Florida
New Orleans, Louisiana Melatonin (N-Acetyl-5-Methoxytryptamine, Bevitamel, Diaphragmatic Hernia (Congenital)
Hypertension, Uncontrolled With Cardiomyopathy Vitamist, Melatonex)
David Hallsworth, BA Hons

Jeremy M. Geiduschek, MD Veena Graff, MD (Oxon), BM, BCh, FRCA
Clinical Professor Assistant Professor of Anesthesiology and Critical
Consultant Anaesthetist
Department of Anesthesiology and Pain Medicine Care
Oxford University Hospitals NHS Foundation Trust
University of Washington School of Medicine Department of Anesthesiology and Critical Care
Oxford, United Kingdom
Acting Director, Department of Anesthesiology and Perelman School of Medicine at the University of
Von Hippel-Lindau Disease
Pain Medicine Pennsylvania
Director of Cardiovascular Anesthesiology Philadelphia, Pennsylvania
Seattle Children’s Hospital Buprenorphine Travis W. Hammond, DO
Seattle, Washington Raynaud Phenomenon Senior Resident
Mitochondrial Myopathy Department of Anesthesiology
West Virginia University
Nikolaus Gravenstein, MD
Rebecca M. Gerlach, MD, FRCPC Professor of Anesthesiology
Herpes, Type I
Assistant Professor University of Florida College of Medicine
Director, Anesthesia Perioperative Medicine Clinic Gainesville, Florida
Department of Anesthesia and Critical Care Diuretics Karen Hand, MB, BS
University of Chicago Department of Anesthesiology
Chicago, Illinois Oregon Health and Science University
Churg-Strauss Syndrome Karina Gritsenko, MD Portland, Oregon
Program Director, Regional Anesthesia and Acute Pain Anaphylaxis
Medicine Fellowship
Ghaleb A. Ghani, MB BCh Director, Regional Anesthesia and Acute Pain
Associate Professor Medicine Resident Rotations Raafat S. Hannallah, MD, FAAP
Department of Anesthesiology Assistant Professor of Anesthesiology, Family and Professor Emeritus of Anesthesiology and Pediatrics
Emory University Medical School Social Medicine, and Physical Medicine and George Washington University School of Medicine
Atlanta, Georgia Rehabilitation Division of Anesthesiology, Pain and Perioperative
Glomus Jugulare Tumors Albert Einstein College of Medicine Medicine
Montefiore Medical Center Children’s National Health System
New York, New York Washington, District of Columbia
Colchicine Anhidrosis (Congenital Anhidrotic Ectodermal Dysplasia)
xiv
Contributors
C. William Hanson III, MD, FCCM John A. Helmstetter, MD Charles W. Hogue Jr., MD
Professor of Anesthesiology and Critical Care Anesthesia Resident Professor of Anesthesiology and Critical Care
Hospital of the University of Pennsylvania LSU Health Sciences Center Medicine
Philadelphia, Pennsylvania New Orleans, Louisiana Chief
Bronchitis, Chronic Evening Primrose Division of Adult Anesthesia
Hypercalcemia Johns Hopkins University School of Medicine
Charles B. Hantler, MD Lithium Carbonate (Lithobid) Johns Hopkins Hospital
Baltimore, Maryland
Professor
Department of Anesthesiology Adrian Hendrickse, BM, FRCA Chagas Disease
Washington University School of Medicine Associate Professor
St. Louis, Missouri Department of Anesthesiology Natalie F. Holt, MD, MPH
Adrenal Insufficiency, Acute or Secondary University of Colorado Assistant Professor
Aurora, Colorado Department of Anesthesiology
Jonathan G. Hardman, BMedSci Disseminated Intravascular Coagulation Yale School of Medicine
New Haven, Connecticut
(Hons), BM, BS, FANZCA, FRCA,
DM Greg Hertel, MD Staff Anesthesiologist and Medical Director
Ambulatory Procedures Unit
Resident
Professor and Head of Department Veterans Affairs Healthcare System, West Haven
Anaesthesia and Critical Care Campus
University of Pennsylvania
School of Medicine West Haven, Connecticut
University of Nottingham Diabetes Insipidus
Hepatopulmonary Syndrome
Nottingham, United Kingdom
Hyperaldosteronism, Primary
Hyperaldosteronism, Secondary Eric J. Heyer, MD, PhD Jiri Horak, MD
Anesthesiology Resident
Professor Emeritus of Anesthesiology and Neurology
Matthew Hart, MS, CRNA Special Research Scientist
Department of Neurological Surgery University of Pennsylvania
Chief Nurse Anesthetist Philadelphia, Pennsylvania
Columbia University
Department of Anesthesia and Perioperative Medicine Noonan Syndrome
New York, New York
Cerebrovascular Transient Ischemic Attack
Portland, Oregon
Bronchiectasis Lyndsay M. Hoy, MD
James G. Hilliard, MS, CRNA Clinical Instructor
Hospital of the University of Pennsylvania
CONTRIBUTORS
Timothy Heinke, MD Instructor, School of Medicine
Department of Anesthesia and Perioperative Medicine Philadelphia, Pennsylvania
Assistant Professor of Anesthesia Neuroleptic Malignant Syndrome
Medical University of South Carolina Selective Estrogen Receptor Modulators
Portland, Oregon
Charleston, South Carolina
Ginseng
Coronary Artery Disease (Left Main and Non–Left
Main Disease) Nathaniel N. Hsu, MD
Roberta Hines, MD Instructor and OB Anesthesia Fellow
Anesthesiology and Critical Care
Erik M. Helander, MBBS Nicholas M. Greene Professor
Department of Anesthesiology Hospital of the University of Pennsylvania
Anesthesiology Resident Philadelphia, Pennsylvania
Yale University School of Medicine
Louisiana State University Health Sciences Center Abruptio Placentae
New Haven, Connecticut
New Orleans, Louisiana Pregnancy, Intra-Abdominal
Lesch-Nyhan Syndrome
Hypermagnesemia
Opitz-Frias Syndrome (The G Syndrome)
Lipidemias
Stephanie Huang, MD
Mark Helfaer, MD Natalia Hnatiuk, MD Resident Physician
Pediatric Anesthesiologist
Professor of Anesthesiology and Critical Care University of Pennsylvania
Pediatrics and Nursing Philadelphia, Pennsylvania
Medicine
University of Pennsylvania Glucose-6-Phosphate Dehydrogenase Deficiency
American Anesthesiology
Royal Oak, Michigan
Friedreich Ataxia
Subclavian Steal Syndrome Julie L. Huffmyer, MD
Associate Professor of Anesthesiology
Joshua A. Heller, MD Anthony M.-H. Ho, MD, FRCPC, Department of Anesthesiology
Assistant Professor University of Virginia
Icahn School of Medicine at Mount Sinai FCCP Charlottesville, Virginia
Mount Sinai West and Mount Sinai St. Luke’s Professor and Director of Pediatric Anesthesia Cystic Fibrosis
Hospitals Department of Anesthesiology and Perioperative
New York, New York Medicine
Marfan Syndrome Queen’s University Hayden R. Hughes, JD, MD
Kingston, Canada Assistant Professor
Tracheoesophageal Fistula (Congenital) University of Alabama at Birmingham
Lori B. Heller, MD Birmingham, Alabama
Medical Director Anemia, Chronic Disease/Inflammation
Swedish Blood Management Program Rosemary M.G. Hogg, MB, ChB,
Department of Anesthesiology FRCA, MD James W. Ibinson, MD, PhD
Division of Cardiac Anesthesia Consultant Anaesthetist
Assistant Professor
Clinical Instructor Belfast Health and Social Care Trust
Department of Anesthesiology and Clinical and
University of Washington Belfast, Northern Ireland
Translational Science Institute
Seattle, Washington Chondroitin Sulfate
University of Pittsburgh
Pseudoephedrine
Glaucoma, Open-Angle
xv
Contributors
Karen E. Iles, PhD Andrea Johnson, DO Adam M. Kaye, PharmD, FASCP,

Associate Professor Pediatric Anesthesiology Fellow FCPhA
University of Alabama at Birmingham Department of Anesthesiology and Perioperative Clinical Professor of Pharmacy
Birmingham, Alabama Medicine Department of Pharmacy Practice
Folic Acid Oregon Health and Science University Thomas J. Long School of Pharmacy and Health
Portland, Oregon Sciences
Christina Iliadis, DO Apert Syndrome (Acrocephalosyndactyly Type 1 and 2)
DiGeorge Syndrome
University of the Pacific
Resident Physician Stockton, California
Department of Anesthesiology and Critical Care Androstenedione
Hospital of the University of Pennsylvania David Johnson, MD β-Sitosterol
Philadelphia, Pennsylvania Anesthesiology Resident Tranexamic Acid
Papillomatosis Department of Anesthesiology and Critical Care
Urticaria, Cold University of Pennsylvania Alan David Kaye, MD, PhD
Philadelphia, Pennsylvania Professor and Chair
Robert M. Insoft, MD Dandy-Walker Syndrome Department of Anesthesiology
NICU Medical Director Professor
Newborn Medicine Jordan B. Johnson, MD Department of Pharmacology
Brigham and Women’s Hospital Resident in Anesthesiology Louisiana State University Health Sciences Center
Boston, Massachusetts Department of Anesthesiology and Perioperative New Orleans, Louisiana
Necrotizing Enterocolitis Medicine Acidosis, Renal Tubular
Oregon Health and Science University Alagille Syndrome
Amyotrophic Lateral Sclerosis
Michael G. Irwin, MB, ChB, MD, Portland, Oregon
Acquired Immunodeficiency Syndrome Androstenedione
FRCA, FCAI, FANZCA, FHKAM Antipsychotics
Head β-Sitosterol
Department of Anaesthesiology Mark R. Jones, MD Bipolar Disorder
University of Hong Kong Resident Physician Blue Cohosh (Caulophyllum thalictroides)
Chief of Service Department of Anesthesiology, Critical Care, and Pain Bulimia Nervosa
Queen Mary Hospital Medicine Cerebral Palsy
Hong Kong, China Beth Israel Deaconess Medical Center Cranberry
Nonstatin Hypolipidemic Agents Harvard Medical School Dandelion
Boston, Massachusetts Dehydroepiandrosterone
Androstenedione
Unyime S. Ituk, MBBS, FCARCSI
CONTRIBUTORS
Drug Abuse, Lysergic Acid Diethylamide

β-Sitosterol Echinococcosis
Assistant Professor Cerebral Palsy
Department of Anesthesia Ehlers-Danlos Syndrome
Echinococcosis Evening Primrose
University of Iowa Ginger (Zingiber officinale)
Iowa City, Iowa Fish Oil
Glycine Galactosemia
Cardiomyopathy, Peripartum Hyperkalemia Garlic (Allium sativum)
Nutraceuticals Ginger (Zingiber officinale)
Bozena R. Jachna, MD Nutritional Support Gingko biloba
Instructor Glucocorticoids
Harvard Medical School Edmund H. Jooste, MD Glycine
Department of Anesthesia, Critical Care and Associate Professor of Anesthesiology Gout
Perioperative Medicine Clinical Director of Pediatric Cardiac Anesthesiology Headache, Migraine
Beth Israel Deaconess Medical Center Department of Anesthesiology, Pediatric Division Hepatitis, Alcoholic
Boston, Massachusetts Duke University Herpes, Type II
Phenytoin Durham, North Carolina Hypercalcemia
Coarctation of the Aorta Hyperkalemia
Pankaj Jain, MD Hypermagnesemia
Hypernatremia
Cardiothoracic Anesthesiology Fellow Matthew B. Jordan, MD Hypertension, Uncontrolled With Cardiomyopathy
Department of Cardiothoracic Anesthesiology Resident
Cleveland Clinic Hyponatremia
Cleveland, Ohio Hypopituitarism
West Virginia University School of Medicine
Cardiomyopathy, Restrictive Lipidemias
Lithium Carbonate (Lithobid)
Rifampin
Multiple Myeloma
Michael F.M. James, MBChB, PhD, Myotonia Dystrophica (Myotonic Dystrophy, Steinert
FRCA, FCA(SA) Zeev N. Kain, MD, MBA Disease)
Emeritus Professor Professor and Chair Nutraceuticals
Department of Anaesthesia and Perioperative Department of Anesthesiology and Perioperative Care Nutritional Support
Medicine University of California Irvine School of Medicine Red Yeast Rice (Cholestin)
University of Cape Town Irvine, California S-Adenosyl-L-Methionine
Cape Town, South Africa Cocaine Schizophrenia
Thyroid Neoplasms Neurofibromatosis Tetracyclines
Tissue Plasminogen Activator
Adrian P. Jennings, MA, BM, BCh, Meredith Ann Kato, MD Tranexamic Acid
Wegener Granulomatosis (Granulomatosis With
MRCP, FRCA, PGCME Assistant Professor
Polyangiitis)
Consultant Anaesthetist Department of Anesthesiology and Perioperative
The Dudley Group of Hospitals NHS Foundation Medicine
Trust Oregon Health and Science University Jessica Kaye
West Midlands, United Kingdom Portland, Oregon Undergraduate
Takayasu Disease Preterm Infant University of Pacific Pharmacy School
Stockton, California
Androstenedione
xvi
Contributors
Rachel J. Kaye Todd J. Kilbaugh, MD Arthur Kitt, MD, MPH

Undergraduate Assistant Professor of Anesthesiology, Critical Care Assistant Professor of Anesthesiology and Critical
Department of Biochemistry Medicine, and Pediatrics Care
Bowdoin College Department of Anesthesiology and Critical Care Pain Medicine Division
Brunswick, Maine Medicine Hospital of the University of Pennsylvania
Bipolar Disorder The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania
Dehydroepiandrosterone Perelman School of Medicine at the University of Reflex Sympathetic Dystrophy (Complex Regional Pain
Fish Oil Pennsylvania Syndrome)
Galactosemia Philadelphia, Pennsylvania
Glycine
Hyperkalemia
Atrial Septal Defect, Ostium Primum
Kawasaki Disease
Ryan J. Kline, MD
Resident
Lipidemias Department of Anesthesiology
Nutritional Support Shanique Brown Kilgallon, MD Louisiana State University Health Science Center
Assistant Professor New Orleans, Louisiana
A. Murat Kaynar, MD, MPH Anesthesiology and Critical Care Medicine Multiple Myeloma
Associate Professor The Children’s Hospital of Philadelphia
Program Director, Anesthesiology Critical Care
Medicine Fellowship
Apnea of the Newborn
Rebecca Y. Klinger, MD, MS
Assistant Professor
Departments of Critical Care Medicine and Department of Anesthesiology
Anesthesiology
University of Pittsburgh School of Medicine
David Y. Kim, MD Division of Cardiothoracic Anesthesia
Staff Anesthesiologist Duke University
Pittsburgh, Pennsylvania Team Health/Dignity Health System Durham, North Carolina
Necrotizing Fasciitis San Francisco, California Myxoma
Complement Deficiency
Miklos D. Kertai, MD, PhD Joshua Knight, MD
Associate Professor of Anesthesiology with Tenure
Jerry H. Kim, MD Resident Physician
Assistant Professor Department of Anesthesiology
Duke University Medical Center Department of Anesthesiology and Pain Medicine University of Pittsburgh Medical Center
Durham, North Carolina Seattle Children’s Hospital Pittsburgh, Pennsylvania
Congestive Heart Failure Seattle, Washington Atrioventricular and Bifascicular Heart Block
Mitochondrial Myopathy
Mary A. Keyes, MD Paul R. Knight III, MD, PhD
CONTRIBUTORS
Clinical Professor of Anesthesiology
Michael R. King, MD SUNY Distinguished Professor
Instructor Anesthesiology
David Geffen School of Medicine Northwestern University Feinberg School of Medicine State University of New York at Buffalo
University of California Los Angeles Attending Anesthesiologist Buffalo, New York
Los Angeles, California Lurie Children’s Hospital of Chicago IgA Deficiency
Reye Syndrome Chicago, Illinois Immune Suppression
Malignant Hyperthermia and Other Anesthetic-Induced Q Fever
Sabry Khalil, MD Myodystrophies Rocky Mountain Spotted Fever
Staff Neuroanesthesiologist
Ochsner Health System
Jeffrey R. Kirsch, MD W. Andrew Kofke, MD, MBA,
Assistant Professor
Professor and Chair FCCM
Department of Anesthesiology and Perioperative Professor
University of Queensland Medicine Director of Neuroanesthesia
Brisbane, Australia Associate Dean for Clinical and Veterans Affairs Co-Director of Neurocritical Care
Multiple Sclerosis Oregon Health and Science University Departments of Anesthesia and Neurosurgery
Portland, Oregon University of Pennsylvania
Robyna Irshad Khan, FCPS (Anes- Acquired Immunodeficiency Syndrome Philadelphia, Pennsylvania
thesiology), MHSc (Bioethics) Amphetamines Seizures, Epileptic
Associate Professor Bronchiectasis
Cogan Syndrome
Department of Anaesthesiology
Aga Khan University De Morsier Syndrome Antoun Koht, MD
Foreign Body Aspiration Professor
Karachi, Pakistan
Gastrinoma Departments of Anesthesiology, Neurological Surgery,
Hormone Replacement Therapy
Ginseng and Neurology
Histiocytosis Northwestern University Feinberg School of Medicine
Wajid M. Khan, MBBS, FCPS, Lambert-Eaton Myasthenic Syndrome Chicago, Illinois
FCAI, DPMCAI Marijuana Infratentorial Tumors
Anesthesiologi Pericardial Effusion Supratentorial Brain Tumors
Mater Misericordiae University Hospital Thiazolidinediones
University College Vitamin K Deficiency Guy Kositratna, MD
Dublin, Ireland Wolff-Parkinson-White Syndrome Visiting Scholar
Lymphomas Department of Anesthesiology and Critical Care
John Kissko III, BCE, MS, MD University of Pennsylvania
Puneet Khanna, MBBS, MD Assistant Professor of Clinical Anesthesiology and Philadelphia, Pennsylvania
Assistant Professor Critical Care Seizures, Epileptic
Department of Anaesthesiology, Pain Medicine and Attending Anesthesiologist
Critical Care Hospital of the University of Pennsylvania Alf Kozian, MD, PhD
All India Institute of Medical Sciences Philadelphia, Pennsylvania Assistant Professor
New Delhi, India Cephalopelvic Disproportion Department of Anesthesiology and Intensive Care
Sturge-Weber Syndrome Ludwig Angina Medicine
Uterine Rupture Otto-von-Guericke-University Magdeburg
Magdeburg, Germany
Niemann-Pick Disease xvii
Contributors
Benjamin H. Krasne, MD Ryan E. Lauer, MD Laeben Lester, MD

Anesthesiologist Assistant Professor Assistant Professor
University of Miami Department of Anesthesiology Department of Anesthesiology and Critical Care
Miami, Florida Loma Linda University School of Medicine Medicine
Carotid Sinus Syndrome Loma Linda, California Johns Hopkins University School of Medicine
Bronchopulmonary Dysplasia Baltimore, Maryland
Molly Kraus, MD Single (Including Common) Ventricle
Senior Associate Consultant Elizabeth Laverriere, MD, MPH
Department of Anesthesiology and Perioperative Resident Physician Jerrold H. Levy, MD, FAHA, FCCM
Medicine Department of Anesthesiology Professor of Anesthesiology, Associate Professor of
Mayo Clinic University of Pennsylvania Surgery
Phoenix, Arizona Philadelphia, Pennsylvania Duke University School of Medicine
Insulinoma Atrial Septal Defect, Ostium Primum Co-Director, Cardiothoracic ICU
Duke University Hospital
Nathan Kudrick, MD Ronit Lavi, MD Durham, North Carolina
Allergy
Assistant Professor Associate Professor and Director of Resident Research
Anticoagulation, Preoperative
Department of Anesthesiology and Perioperative Care Department of Anesthesia and Perioperative Medicine
University of California Irvine University of Western Ontario
Irvine, California London, Canada Nicholas A. Levy, MBBS, FRCA,
Rheumatoid Arthritis Patent Foramen Ovale FFICM, BSc
Consultant in Anaesthesia and Perioperative Medicine
Madhuri S. Kurdi, MD Chris C. Lee, MD, PhD Department of Anaesthesia and Perioperative
Professor Associate Professor Medicine
Department of Anesthesiology Department of Anesthesiology West Suffolk Hospital
Karnataka Institute of Medical Sciences Washington University Suffolk, England
Hubli, India St. Louis, Missouri Metformin (Glucophage)
Henoch-Schönlein Purpura Scoliosis and Kyphosis Oral Hypoglycemic Agents
Carmen Labrie-Brown, MD H. Thomas Lee, MD, PhD Kristen L. Lienhart, MD

Assistant Professor of Clinical Anesthesiology Professor and Director of Transplantation Anesthesiology Assistant Professor
Louisiana State University Health Sciences Center Department of Anesthesiology Department of Anesthesiology
CONTRIBUTORS
School of Medicine Columbia University Medical Center University of Arkansas for Medical Sciences
New Orleans, Louisiana New York, New York Little Rock, Arkansas
Cerebral Palsy Riley-Day Syndrome (Familial Dysautonomia, Hereditary Diabetes, Type III (Gestational Diabetes Mellitus)
and Sensory Autonomic Neuropathy Type III)
J. Lance LaFleur, MD, MBA Karen S. Lindeman, MD
Department of Anesthesiology Marshall K. Lee, MD Associate Professor
University of Texas Medical School Assistant Professor Department of Anesthesiology/Critical Care Medicine
Houston, Texas Department of Anesthesiology and Perioperative The Johns Hopkins University
Pyridostigmine Bromide Medicine Baltimore, Maryland
Oregon Health and Science University Placenta Previa
Kirk Lalwani, MB, BS, FRCA, MCR Portland, Oregon
Professor of Anesthesiology and Pediatrics Complement Deficiency Regina Linganna, MD
Vice-Chair for Faculty Development Resident Physician
Director, Pediatric Anesthesiology Fellowship Program Susan M. Lee, MD, FRCPC, MAS Department of Anesthesiology and Critical Care
Anesthesiology and Perioperative Medicine (Clinical Research) Hospital of the University of Pennsylvania
Oregon Health and Science University Assistant Adjunct Professor
Portland, Oregon Long QT Syndrome
University of California San Francisco
Anemia, Hemolytic San Francisco, California
Central Neurogenic Hyperventilation Anesthesiologist Ronald S. Litman, DO
Echinacea (American Coneflower, Purple Coneflower, E. Royal Columbian Hospital Professor of Anesthesiology and Pediatrics
Angustifolia, E. Purpurea, E. Pallida) New Westminster, Canada Perelman School of Medicine at the University of
Tetanus Nicotine Replacement Therapies Pennsylvania
The Children’s Hospital of Philadelphia
William L. Lanier, MD Mark J. Lema, MD, PhD Philadelphia, Pennsylvania
Professor of Anesthesiology Klippel-Feil Syndrome
SUNY Distinguished Service Professor and Chair
Department of Anesthesiology Malignant Hyperthermia and Other Anesthetic-Induced
Mayo Clinic Myodystrophies
Jacobs School of Medicine and Biomedical Sciences
Rochester, Minnesota University at Buffalo
Hyperglycemia Buffalo, New York Geoffrey L. Liu, BA
Alkylating Agents Medical Student
Gregory J. Latham, MD Bleomycin Tulane University School of Medicine
Associate Professor, Anesthesiology and Pain Medicine New Orleans, Louisiana
Director, Pediatric Cardiac Anesthesiology Fellowship Maggie Lesley, MD Hyperparathyroidism
University of Washington Assistant Professor
Seattle Children’s Hospital Department of Anesthesiology and Critical Care
Seattle, Washington Medicine
Transposition of the Great Arteries Johns Hopkins University School of Medicine
Baltimore, Maryland
Jaundice
xviii
Contributors
Henry Liu, MD S. Nini Malayaman, MD Jonathan B. Mark, MD

Clinical Professor of Anesthesiology Assistant Professor of Anesthesiology Professor of Anesthesiology
Department of Anesthesiology and Perioperative Department of Anesthesiology and Perioperative Duke University Medical Center
Medicine Medicine Chief, Anesthesiology Service
Drexel University College of Medicine, Hahnemann Drexel University College of Medicine, Hahnemann Veterans Affairs Medical Center
University Hospital University Hospital Durham, North Carolina
Philadelphia, Pennsylvania Philadelphia, Pennsylvania Cardiomyopathy, Ischemic
Calcium Deficiency/Hypocalcemia Factor V Leiden Mutation
Factor V Leiden Mutation Sinisa Markovic, MD
Fanconi Syndrome
Graves Disease
Gaurav Malhotra, MD Clinical Assistant Professor
Assistant Professor Department of Anesthesiology
Hyperparathyroidism Department of Anesthesiology Jacobs School of Medicine and Biomedical Sciences
Procainamide (Procan, Procanbid, Pronestyl) Perelman School of Medicine at the University of State University of New York at Buffalo
Pennsylvania Attending Anesthesiologist
Renyu Liu, MD, PhD Philadelphia, Pennsylvania Department of Anesthesiology
Associate Professor Appendicitis, Acute Western New York Healthcare System
Department of Anesthesiology and Critical Care Hepatopulmonary Syndrome Buffalo, New York
Perelman School of Medicine at the University of Portal Hypertension Rocky Mountain Spotted Fever
Pennsylvania
Carnitine Kenneth F. Mancuso, MD, MPH David P. Martin, MD, PhD
Assistant Professor Vice-Chair for Safety and Quality
Department of Anesthesiology Associate Professor of Anesthesiology and
Elvedin Luković, MD, PhD Louisiana State University Health Sciences Center Perioperative Medicine
Resident Physician New Orleans, Louisiana Mayo Clinic
Department of Anesthesiology Tissue Plasminogen Activator Rochester, Minnesota
New York-Presbyterian Hospital Poliomyelitis
The Virginia Apgar Research Fellow
Department of Anesthesiology Mark G. Mandabach, MD
Columbia University Medical Center Assistant Professor Courtney G. Masear, MD
New York, New York Department of Anesthesiology and Perioperative Assistant Professor
Riley-Day Syndrome (Familial Dysautonomia, Hereditary Medicine Department of Anesthesiology and Critical Care
and Sensory Autonomic Neuropathy Type III) University of Alabama at Birmingham School of Medicine
Medicine The Johns Hopkins University
CONTRIBUTORS
Birmingham, Alabama Baltimore, Maryland
Philip D. Lumb, MB, BS, MCCM Hepatitis, Halothane Placenta Previa
Keck School of Medicine of the University of Southern
California Dennis T. Mangano, MD, PhD Cory D. Maxwell, MD, FASE
Editor-in-Chief Director and Founder Assistant Professor of Anesthesiology
The Journal of Critical Care McSPI Research Group Durham VA Medical Center
Los Angeles, California San Francisco, California Assistant Professor of Anesthesiology
Lyme Disease Myocardial Ischemia Department of Anesthesiology
Cardiothoracic Division
Astri M.V. Luoma, MBChB, FRCA Luiz Maracaja, MD Duke University
Durham, North Carolina
Consultant Neuroanaesthetist Assistant Professor
Cardiomyopathy, Ischemic
National Hospital for Neurology and Neurosurgery Department of Anesthesiology
University College London Hospitals NHS University of Texas Health Science Center at San
Foundation Trust Antonio Lynne G. Maxwell, MD, FAAP
London, United Kingdom San Antonio, Texas Senior Anesthesiologist
Creutzfeldt-Jakob Disease Mitral Regurgitation Department of Anesthesiology and Critical Care
Pertussis (Whooping Cough) Medicine
Anne M. Lynn, MD The Children’s Hospital of Philadelphia
Professor, Anesthesiology and Pediatrics (Adjunct) Inna Maranets, MD Emeritus Professor, Anesthesiology and Critical Care
University of Washington School of Medicine Assistant Professor
Pennsylvania
Seattle Children’s Hospital Department of Anesthesiology
Seattle, Washington University of Connecticut School of Medicine
Duodenal Atresia
Jeune Syndrome (Asphyxiating Thoracic Dystrophy) Attending Anesthesiologist
St. Francis Hospital and Medical Center
Jonathan G. Ma, MD Hartford, Connecticut C. David Mazer, MD, FRCPC
Resident Eisenmerger Syndrome Professor of Anesthesia and Physiology
Department of Anesthesiology Pyloric Stenosis Department of Anesthesia
Louisiana State University Treacher Collins Syndrome Keenan Research Center in the Li Ka Shing
New Orleans, Louisiana Knowledge Institute of St. Michael’s Hospital
Gingko biloba Piedad Cecilia Echeverry Marín, University of Toronto
Toronto, Canada
Herpes, Type II
Hypernatremia
MD Cilostazol
Pediatric Anesthesiologist
Hypertension, Uncontrolled With Cardiomyopathy Coordinator of National Committee of Pediatric
Hypopituitarism Anesthesia Niamh A. McAuliffe, MBBCh,
Tetracyclines Colombian Society of Anesthesia FCARCSI, FRCPC
Instituto de Ortopedia Infantil Roosevelt Staff Anesthesiologist
Emily J. MacKay, DO Bogota, Colombia St. Michael’s Hospital
Cardiothoracic Anesthesia Fellow Scimitar Syndrome Lecturer
Department of Anesthesiology and Critical Care University of Toronto
Hospital of the University of Pennsylvania Toronto, Canada
Philadelphia, Pennsylvania Cilostazol
Pneumonia, Community-Acquired
xix
Contributors
Brenda C. McClain, MD Kevin Miller, MD Roger A. Moore, MD

Professor Resident in Anesthesiology and Critical Care Associate Professor of Clinical Anesthesiology and
Department of Anesthesiology and Critical Care Department of Anesthesiology and Critical Care Critical Care
Saint Louis University Hospital of the University of Pennsylvania Department of Anesthesiology and Critical Care
St. Louis, Missouri Philadelphia, Pennsylvania Perelman School of Medicine at the University of
Cleft Palate Gold (Auranofin, Aurothioglucose, Aurothiomalate) Pennsylvania
Klinton McGhee, MD Wanda C. Miller-Hance, MD Anomalous Pulmonary Venous Drainage
Cancer, Lung Parenchyma
Research Fellow Professor of Anesthesiology and Pediatrics
Rheumatic Fever (Acute) and Rheumatic Heart Disease
Department of Anesthesiology Baylor College of Medicine
The Ohio State University Associate Director of Pediatric Cardiovascular
Wexner Medical Center Anesthesiology Klaus Morales dos Santos, MD
Columbus, Ohio Texas Children’s Hospital Staff Anesthesiologist
Acute Intermittent Porphyria Division of Pediatric Cardiovascular Anesthesiology Hospital e Maternidade Santa Joana
Houston, Texas São Paulo, Brazil
Jason L. McKeown, MD Ebstein Anomaly Cri Du Chat Syndrome (5P– Syndrome)
Osteogenesis Imperfecta
Medical Anesthesia Group, PA
Affiliate Faculty Mohammed M. Minhaj, MD, MBA
University of Tennessee Health Science Center, College Vice-Chair for Finance and Operations Debra E. Morrison, MD, FAAP
of Medicine Associate Chair for Faculty Development Health Sciences Clinical Professor
Memphis, Tennessee Department of Anesthesia and Critical Care University of California, Irvine School of Medicine
Capsaicin University of Chicago Medicine Director, Pediatric and Neonatal Anesthesia
Chicago, Illinois Department of Anesthesiology & Perioperative Care
Thomas M. McLoughlin Jr., MD Amniotic Fluid Embolism Medical Director for Sedation
University of California, Irvine Medical Center
Chair, Department of Anesthesiology
Lehigh Valley Health Network Nanhi Mitter, MD Orange, California
Botulism
Allentown, Pennsylvania, Professor of Surgery, Assistant Professor
Division of Surgical Anesthesiology Department of Anesthesiology and Critical Care
University of South Florida Morsani School of Medicine Claudie Mouton-Faivre, MD
Medicine Johns Hopkins Hospital Service de Dermato-Allergologie & Consultation
Tampa, Florida Baltimore, Maryland d’Allergo-Anesthésie
Coagulopathy, Factor IX Deficiency Chagas Disease Centre Hospitalier Universitaire de Nancy, Hôpital de
CONTRIBUTORS
Von Willebrand Disease Brabois

Alexander J.C. Mittnacht, MD Vandœuvre-lès-Nancy, France
Julie R. McSwain, MD, MPH Professor of Anesthesiology Mastocytosis
Assistant Professor Icahn School of Medicine at Mount Sinai
Department of Anesthesia and Perioperative Medicine Director, Pediatric Cardiac Anesthesia John R. Moyers, MD
Medical University of South Carolina Department of Anesthesiology Professor
Charleston, South Carolina Mount Sinai Medical Center Department of Anesthesia
Charcot-Marie-Tooth Disease New York, New York Carver College of Medicine
Ventricular Septal Defect (Congenital) University of Iowa
Diana Mekler, MD Iowa City, Iowa
Physical Medicine and Rehabilitation, Interventional Pain Raj K. Modak, MD Mesothelioma
Louisiana State University Assistant Professor of Anesthesiology
New Orleans, Louisiana Department of Anesthesiology Jesse J. Muir, MD
Headache, Migraine Yale University School of Medicine Assistant Professor
New Haven, Connecticut Department of Anesthesiology
William T. Merritt, MD, MBA Mitral Regurgitation
Pertussis (Whooping Cough)
Mayo Clinic Hospital
Phoenix, Arizona
Faculty
Insulinoma
Departments of Anesthesiology/Critical Care
Medicine and Surgery Pierre Moine, MD, PhD
Johns Hopkins Hospital Associate Professor Ray Munroe, MD
School of Arts and Sciences Department of Anesthesiology Anesthesiology Resident
Johns Hopkins University University of Colorado Hospital of the University of Pennsylvania
Baltimore, Maryland Aurora, Colorado Philadelphia, Pennsylvania
Jaundice Cryptococcus Infection Carpenter Syndrome (Acrocephalopolysyndactyly Type II)
Diphtheria Smallpox
David G. Metro, MD
Professor of Anesthesiology Vivek K. Moitra, MD, FCCM John M. Murkin, MD, FRCPC
Vice Chair for Education and Faculty Affairs Allen I. Hyman Associate Professor of Critical Care Department of Anesthesiology and Perioperative
University of Pittsburgh School of Medicine Anesthesiology at CUMC Medicine
Residency Program Director Chief, Division of Critical Care Medicine Schulich School of Medicine
UPMC Medical Education College of Physicians and Surgeons of Columbia University of Western Ontario
Pittsburgh, Pennsylvania University London, Canada
Atrioventricular and Bifascicular Heart Block New York, New York Thyroid Supplements
Hepatic Encephalopathy
David W. Miller, MD Sushila Murthy, MD, MPH
Associate Professor Tiffany Sun Moon, MD Instructor of Anesthesiology and Critical Care
Department of Anesthesiology and Perioperative Assistant Professor Department of Anesthesiology and Critical Care
Medicine Director of Resident Research Hospital of the University of Pennsylvania
University of Alabama at Birmingham Department of Anesthesiology and Pain Management Philadelphia, Pennsylvania
Birmingham, Alabama University of Texas Southwestern Medical Center Dipyridamole
Folic Acid Dallas, Texas
xx Methemoglobinemia
Contributors
Paul S. Myles, MB, MPH, MD, Viet Nguyen, MD Sinead Nyhan, MD

FCAI, FANZCA, FRCA, FAHMS Assistant Professor Anesthesiology Resident
Professor and Director of Anaesthesia and Department of Anesthesiology Department of Anesthesiology and Critical Care
Perioperative Medicine Louisiana State University Health Sciences Center Medicine
Alfred Hospital and Monash University School of Medicine Johns Hopkins Medicine
Melbourne, Australia New Orleans, Louisiana Baltimore, Maryland
Alpha1-Antitrypsin Deficiency Lithium Carbonate (Lithobid) Single (Including Common) Ventricle
Nader D. Nader, MD, PhD, FACC, Stavroula Nikolaidis, MD Peter M. Odor, BM, BCh, MA,
FCCP Associate Professor of Anesthesiology FRCA
Department of Anesthesiology Anaesthetic Specialist Registrar
Professor of Anesthesiology and Surgery
Texas A&M University St. George’s University Hospital
Research Professor of Pathology and Anatomical
Baylor Scott and White Healthcare London, United Kingdom
Sciences
Temple, Texas Ventricular Preexcitation Syndrome
State University of New York at Buffalo
Cardiomyopathy, Hypertrophic
Buffalo, New York
Immune Suppression Sheri Jones Oguh, MD
Sara Nikravan, MD Resident
Abhijit S. Nair, MD, FWAMS Assistant Professor
Director of Critical Care Ultrasound
Consultant Anesthesiologist University of Pennsylvania
Cardiac Anesthesiology and Critical Care Medicine Philadelphia, Pennsylvania
Basavatarakam Indo-American Cancer Hospital and
Stanford University Pompe Disease
Research Institute
Stanford, California
Hyderabad, India
Syndrome of Inappropriate Antidiuretic Hormone
Digitalis (Digoxin) Andrew Oken, MD
Associate Professor
Manchula Navaratnam, MBChB, Dolores B. Njoku, MD Department of Anesthesiology
Associate Professor
FRCA Anesthesiology and Critical Care Medicine, Pediatrics
Assistant Chief, Department of Anesthesiology
Clinical Assistant Professor and Pathology Section Chief, Cardiothoracic Anesthesiology
Department of Anesthesiology, Perioperative and Pain Johns Hopkins University Operative Care Division
Medicine Baltimore, Maryland Portland VA Medical Center
Stanford Children’s Hospital Subclavian Steal Syndrome Portland, Oregon
Palo, Alto, California
CONTRIBUTORS
Cardiomyopathy, Dilated
Truncus Arteriosus
Mary J. Njoku, MD Pulmonary Fibrosis, Idiopathic
Associate Professor
Mark T. Nelson, MD, MEd Department of Anesthesiology Onyi Onuoha, MD, MPH
Assistant Professor University of Maryland School of Medicine Assistant Professor of Clinical Anesthesiology
Department of Anesthesiology Baltimore, Maryland Department of Anesthesiology and Critical Care
Virginia Commonwealth University Encephalitis Medicine
Richmond, Virginia
Pulmonary Atresia
Katherine L. Norgaard, MD Pennsylvania
Instructor of Anesthesiology and Critical Care Hospital of the University of Pennsylvania
Edward C. Nemergut, MD Medicine Philadelphia, Pennsylvania
Frederic A. Berry Professor of Anesthesiology Johns Hopkins Medical Institutions Pregnancy-Induced Hypertension
Professor of Neurosurgery Baltimore, Maryland Vitamin B12/Folate Deficiency
Department of Anesthesiology Anemia, Megaloblastic
University of Virginia
Charlottesville, Virginia Nathan G. Orgain, MD
Cystic Fibrosis Fredrick Ntumy, MD Assistant Professor of Anesthesiology
Clinical Anesthesia Resident University of Utah School of Medicine
Pituitary Tumors
Department of Anesthesiology Salt Lake City, Utah
Oakland University William Beaumont School of Cigarette Smoking Cessation
Michael E. Nemergut, MD, PhD Medicine
Assistant Professor
Department of Anesthesiology and Preoperative
Royal Oak, Michigan Pedro Orozco, MD
Hemosiderosis, Pulmonary Clinical Instructor
Medicine
Mayo Clinic
Rochester, Minnesota Danuza Nunn, MS, CCC-SLP University of California Irvine
Speech Language Pathologist Irvine, California
Sickle Cell Disease
Massachusetts General Hospital Rheumatoid Arthritis
Boston, Massachusetts
Bradley K.W. Ng, MD, FRANZCP Swallowing Disorders Andreas M. Ostermeier, MD
Psychiatrist
Physician
Robina Private Hospital
Gold Coast Hospital and Health Service Ijeoma Nwachukwu, MD Clinic for Anesthesiology
Resident Physician University of Munich
Queensland, Australia
Department of Anesthesiology and Critical Care Munich, Germany
Obsessive-Compulsive Disorder
Hospital of the University of Pennsylvania Sleep Apnea, Central and Mixed
Thai T. Nguyen, MD, PhD Antianxiety Medications Ira Padnos, MD
Assistant Professor
Assistant Professor
Medicine Omonele O. Nwokolo, MD Department of Anesthesiology
Assistant Professor Louisiana State University School of Medicine
Johns Hopkins University
Department of Anesthesiology New Orleans, Louisiana
Baltimore, Maryland
University of Texas Lithium Carbonate (Lithobid)
ACE Inhibitors
Houston, Texas
Purpura, Thrombotic Thrombocytopenic
xxi
Contributors
Christopher R. Page, MD Prakash A. Patel, MD Philip Peng, MBBS, FRCPC,

Assistant Professor of Anesthesiology Assistant Professor Founder (Pain Medicine)
Director, Acute Pain Service Department of Anesthesiology and Critical Care Professor
Stony Brook Medical Center Perelman School of Medicine at the University of Department of Anesthesiology and Pain Management
Stony Brook, New York Pennsylvania University Health Network and Mount Sinai Hospital
Nonsteroidal Anti-Inflammatory Drugs Philadelphia, Pennsylvania University of Toronto
Shy-Drager Disease Toronto, Canada
Paul S. Pagel, MD, PhD Osteoarthritis
Staff Physician Saumil J. Patel, MD
Anesthesia Service Housestaff Austin J. Peters, MD
Clement J. Zablocki Veterans Affairs Medical Center Department of Anesthesiology and Critical Care Anesthesiology Resident
Milwaukee, Wisconsin University of Pennsylvania Health System Department of Anesthesiology & Perioperative
Endocardial Cushion Defect (Atrioventricular Canal) Philadelphia, Pennsylvania Medicine
Shy-Drager Disease Oregon Health and Science University
Nirvik Pal, MBBS, MD Portland, Oregon
Assistant Professor Johanna Paterson, MBBS, BSc, Pericardial Effusion
Department of Anesthesiology FRCA, DipIMC
Virginia Commonwealth University Consultant Anaesthetist Charise T. Petrovitch, MD
Richmond, Virginia James Cook University Hospital Clinical Professor
Pulmonary Atresia Middlesborough, United Kingdom Department of Anesthesiology and Critical Care
P2Y12 Receptor Blockers Medicine
Ryan Palacio, MD George Washington University Hospital
Obstetric Anesthesiology Fellow Shilpadevi S. Patil, MD Chief
Anesthesia Section
Department of Anesthesiology and Critical Care Clinical Assistant Professor and Program Director
University of Chicago Department of Anesthesiology VA Medical Center
Chicago, Illinois Louisiana State University Health Sciences Center Washington, District of Columbia
Amniotic Fluid Embolism Shreveport, Louisiana Warfarin (Coumadin)
Tranexamic Acid
Tyler J. Paradis, MD Ethan Phan, MPH
Resident Anesthesiologist Olga Pawelek, MD Medical Student
Louisiana State University School of Medicine
Department of Anesthesiology and Perioperative Clinical Assistant Professor
CONTRIBUTORS
Medicine New Orleans, Louisiana

Oregon Health and Science University Dehydroepiandrosterone
University of Texas Health Science Center
Portland, Oregon Hyponatremia
Houston, Texas
Histiocytosis Purpura, Immune Thrombocytopenic
Dennis Phillips, DO
Megha Parekh, MD Ronald G. Pearl, MD, PhD Clinical Assistant Professor
Resident Physician Anesthesiology and Critical Care Medicine
Dr. Richard K. and Erika N. Richards Professor and
Department of Anesthesia and Perioperative Care University of Pittsburgh
Chair
University of California San Francisco School of Pittsburgh, Pennsylvania
Medicine Atrioventricular and Bifascicular Heart Block
Medicine
San Francisco, California Stanford University School of Medicine
Atrial Flutter Stanford, California Mark C. Phillips, MD
Pulmonary Embolism Assistant Professor
Richard K. Patch III, MD Department of Anesthesiology and Perioperative
Assistant Professor of Anesthesiology and Medicine Alessia Pedoto, MD Medicine
University of Alabama at Birmingham School of
Division of Critical Care Medicine, Department of Associate Attending
Anesthesiology and Perioperative Medicine Medicine
Memorial Sloan Kettering Cancer Center
Division of Pulmonary and Critical Care Medicine, Birmingham, Alabama
Department of Anesthesia and Critical Care Medicine
Department of Medicine Crohn Disease
New York, New York
Mayo Clinic Cancer, Esophageal
Rochester, Minnesota Lauren M. Nakazawa, MD
Renal Failure, Acute
Christine Peeters-Asdourian, MD Regional Anesthesiology and Acute Pain Medicine
Fellow
Director, BIDMC Pain Medicine Fellowship
Alopi Patel, MD Beth Israel Deaconess Medical Center Department of Anesthesiology
Resident Hospital for Special Surgery
Boston, Massachusetts
Department of Anesthesiology, Pain and Perioperative New York, New York
Assistant Professor of Anesthesia
Medicine Stevens-Johnson Syndrome
Icahn School of Medicine Harvard University Medical School
Mount Sinai St. Luke’s and West Hospitals Cambridge, Massachusetts Alexandria Piedmont, MD
New York, New York Herniated Nucleus Pulposus Anesthesiology Resident
Jehovah’s Witness Patient Department of Anesthesiology and Critical Care
Annie Lynn Penaco, MD University of Pennsylvania
Dilipkumar K. Patel, MD Pediatric Anesthesia Fellow Philadelphia, Pennsylvania
Associate Professor Pancreatitis
Lewis Katz School of Medicine at Temple University The Children’s Hospital of Pittsburgh of UPMC
Philadelphia, Pennsylvania Pittsburgh, Pennsylvania Evan G. Pivalizza, MD
Hypercholesterolemia Hirschsprung Disease Distinguished Teaching Professor
Leukemia Department of Anesthesiology
University of Texas Health Science Center
Houston, Texas
Purpura, Immune Thrombocytopenic
Purpura, Thrombotic Thrombocytopenic
xxii
Contributors
Nathan Poiro, MD Bronwyn R. Rae, MD, FANZCA, Norman Randolph, MD

Assistant Professor MPH Assistant Professor of Clinical Anesthesiology and
Department of Anesthesiology Attending Anesthesiologist Critical Care
Temple University Hospital Department of Anesthesiology Department of Anesthesiology and Critical Care
Philadelphia, Pennsylvania Lake Forest Hospital Hospital of the University of Pennsylvania
Leukemia Lake Forest, Illinois Philadelphia, Pennsylvania
Congenital Methemoglobinemia Proton Pump Inhibitors
Jahan Porhomayon, MD, FCCM
Associate Professor Muhammad B. Rafique, MD Girija Prasad Rath, MBBS, MD,
Department of Anesthesiology Associate Professor of Anesthesiology DM
University at Buffalo, The State University of New York McGovern Medical School Professor, Neuroanaesthesiology and Critical Care
Buffalo, New York University of Texas Health Science Center at Houston Neurosciences Centre
IgA Deficiency Houston, Texas All India Institute of Medical Sciences
Tuberculosis New Delhi, India
Amit Prabhakar, MD, MS Nelson Syndrome
Anesthesiology and Critical Care Medicine Fellow Jesse M. Raiten, MD
The Johns Hopkins Hospital Assistant Professor Selina Read, MD
Baltimore, Maryland Anesthesiology and Critical Care Department of Anesthesiology
Acidosis, Renal Tubular University of Pennsylvania Penn State Medical Center
Alagille Syndrome Philadelphia, Pennsylvania Hershey, Pennsylvania
Garlic (Allium sativum) Hyperglycemic Hyperosmolar State Upper Respiratory Infections
Glucocorticoids Multiple Organ Dysfunction Syndrome
Gout
Herpes, Type II Srijaya K. Reddy, MD, MBA
Hypernatremia Arvind Rajagopal, MD Assistant Professor of Anesthesiology and Pediatrics
Hypopituitarism Assistant Professor Division of Anesthesiology, Pain and Perioperative
Multiple Myeloma Rush University Medical Center Medicine
Red Yeast Rice (Cholestin) Chicago, Illinois Children’s National Health System/George
Phenylephrine (Neo-Synephrine) Washington University School of Medicine and
Ventricular Tachycardia Health Sciences
Donald S. Prough, MD Washington, District of Columbia
Rebecca Terry White Distinguished Chair
Department of Anesthesiology Srinivasan Rajagopal, MD Anhidrosis (Congenital Anhidrotic Ectodermal Dysplasia)
CONTRIBUTORS
University of Texas Medical Branch Assistant Professor
Galveston, Texas Department of Cardiothoracic Anesthesia Dallas D. Regan, DNP, CRNA
Renal Failure, Chronic University of Iowa Hospitals Nurse Anesthetist and Senior Instructor
Iowa City, Iowa Oregon Health and Science University
Mesothelioma Portland, Oregon
Bridget Perrin Pulos, MD Thiazolidinediones
Fellow in Regional Anesthesia and Acute Pain
Medicine Mohamed Ehab Ramadan,
Department of Anesthesiology and Critical Care MBBCh, MSC David L. Reich, MD
University of Pennsylvania Research Fellow President and Chief Operating Officer
Philadelphia, Pennsylvania Anesthesiology Department The Mount Sinai Hospital
Glucosamine Sulfate The Ohio State University Wexner Medical Center Horace W. Goldsmith Professor of Anesthesiology,
Columbus, Ohio Perioperative and Pain Medicine
Researcher Assistant of Anesthesiology Icahn School of Medicine at Mount Sinai
Kavitha Pundi, MD Theodor Bilharz Research Institute New York, New York
Advanced Imaging Fellow Ventricular Septal Defect (Congenital)
Giza, Egypt
Department of Pediatric Cardiology Ventricular Septal Rupture (Defect), Postmyocardial
Acute Intermittent Porphyria
Texas Children’s Hospital Infarction
Houston, Texas
Ebstein Anomaly Chandra Ramamoorthy, MD
Professor and Director of Pediatric Cardiac Anesthesia Clare H. Ridley, MD
Department of Anesthesia, Perioperative and Pain Cardiothoracic Anesthesiologist and Intensivist
Ferenc Puskas, MD, PhD Medicine Washington University
Associate Professor St. Louis, Missouri
Stanford Children’s Hospital
Department of Anesthesiology Adrenal Insufficiency, Acute or Secondary
Palo Alto, California
University of Colorado Truncus Arteriosus
Aurora, Colorado
Coronary Artery Spasm James M. Riopelle, MD
Justin D. Ramos, MD Professor of Clinical Anesthesiology
Resident Physician Louisiana State University Health Sciences Center
Aliaksei Pustavoitau, MD, MHS Department of Anesthesiology and Perioperative New Orleans, Louisiana
Assistant Professor Echinococcosis
Medicine
Department of Anesthesiology and Critical Care Oregon Health and Science University
Medicine
Johns Hopkins University School of Medicine
Portland, Oregon Stacey A. Rizza, MD, FIDSA
Acidosis, Lactic/Metabolic Associate Professor of Medicine
Baltimore, Maryland Sepsis, Severe Sepsis, and Septic Shock Department of Infectious Diseases
Jaundice
Thrombocytopenia Mayo Clinic
James A. Ramsey, MD Rochester, Minnesota
Assistant Professor Cytomegalovirus Infection
Carlos A. Puyo, MD, FCCP Department of Anesthesiology
Assistant Professor Multi-Specialty Division
Department of Anesthesiology Vanderbilt University School of Medicine
Division of Clinical and Translational Medicine Nashville, Tennessee
Washington University School of Medicine Syndrome X
St. Louis, Missouri
Mycoplasma pneumoniae Infection xxiii
Contributors
Amy C. Robertson, MD, MMHC Stanley H. Rosenbaum, MA, MD Benjamin Rubin, MD

Assistant Professor Professor of Anesthesiology, Internal Medicine, and Assistant Professor
Department of Anesthesiology Surgery Department of Anesthesiology and Critical Care
Vanderbilt University School of Medicine Director, Division of Perioperative & Adult Anesthesia University of Pennsylvania Health System
Vanderbilt University Medical Center Vice Chairman for Academic Affairs Interim Chief of Anesthesiology
Nashville, Tennessee Department of Anesthesiology Corporal Michael J. Crescenz VA Medical Center
Emphysema Yale School of Medicine Philadelphia, Pennsylvania
Waldenström Macroglobulinemia New Haven, Connecticut Pancreatitis
Carcinoid Syndrome
Stephen T. Robinson, MD Diabetes, Type II (Noninsulin-Dependent) Ryan E. Rubin, MD, MPH
Professor of Anesthesiology and Perioperative Medicine Anesthesiology Resident
Vice Chair for Clinical Anesthesia Andrew D. Rosenberg, MD Department of Anesthesiology
Oregon Health and Science University Chief, Department of Anesthesiology Louisiana State University
Portland, Oregon New York University Hospital for Joint Diseases Shreveport, Louisiana
Trimethaphan Executive Vice Chair, Department of Anesthesiology Hypertension, Uncontrolled With Cardiomyopathy
New York University School of Medicine Pickwickian Syndrome
Jeffrey D. Roizen, MD, PhD New York, New York
Assistant Professor of Pediatrics Cervical Disk Disease (Cervical Spine Disease)
Sarcoidosis
William L. Runcie, MD
Perelman School of Medicine at the University of Chief Resident
Pennsylvania Temple University Hospital
Division of Endocrinology and Diabetes Andrew L. Rosenberg, MD Philadelphia, Pennsylvania
The Children’s Hospital of Philadelphia Interim Chief Information Officer Hypercholesterolemia
Philadelphia, Pennsylvania University of Michigan Health System
Atrial Septal Defect, Ostium Secundum
Croup (Laryngotracheobronchitis)
Ann Arbor, Michigan
Myocardial Contusion (Blunt Cardiac Injury)
Thomas A. Russo, MD, CM
Professor and Chief
Dermatomyositis Division of Infectious Diseases
Epiglottitis
Glycogen Storage Diseases
Meg A. Rosenblatt, MD Vice Chair of Medicine
Professor of Anesthesiology and Orthopaedics Department of Medicine
Malnutrition Icahn School of Medicine at Mount Sinai Jacobs School of Medicine and Biomedical Sciences
Necrotizing Enterocolitis Chair, Department of Anesthesiology, Pain and State University of New York at Buffalo
Patent Ductus Arteriosus Perioperative Medicine Staff Physician
Physiologic Anemia and the Anemia of Prematurity Mount Sinai St. Luke’s and Mount Sinai West Western New York Veterans Administration
CONTRIBUTORS
Hospitals Healthcare System

Michael F. Roizen, MD New York, New York Buffalo, New York
Roizen Family Chair Jehovah’s Witness Patient Q Fever
Wellness Institute
Chief Wellness Officer
Steven Roth, MD Tarang Safi, MD
Professor and Chief, Neuroanesthesia Fellow, Cardiothoracic Anesthesiology
The Cleveland Clinic Department of Anesthesia and Critical Care Stanford University School of Medicine
Cleveland, Ohio University of Chicago Stanford, California
Dermatomyositis Chicago, Illinois Mitral Stenosis
Diabetes Type I (Insulin-Dependent) Postoperative Encephalopathy, Metabolic Transfusion-Related Acute Lung Injury
Hyperthyroidism
Myocardial Ischemia
Phenoxybenzamine Justin L. Rountree, MD Sanjoy Saha, BSc, MBBS, FRCA
Pheochromocytoma Assistant Professor Specialist Registrar in Anaesthesia
Propylthiouracil—Antithyroid Drugs Department of Anesthesiology Barts and The London School of Anaesthesia
Sickle Cell Trait University of North Carolina London, United Kingdom
Sleep Apnea, Central and Mixed Chapel Hill, North Carolina Ventricular Tachyarrhythmias
Sleep Apnea, Obstructive Cushing Syndrome
Misako Sakamaki, MD
Mark D. Rollins, MD, PhD Marc B. Royo, MD, MBA Clinical Assistant Professor
Professor and Sol M. Shnider Endowed Chair for Assistant Professor Department of Anesthesiology and Critical Care
Anesthesia Education Department of Anesthesiology and Critical Care Hospital of the University of Pennsylvania
Director of Obstetric and Fetal Anesthesia University of Pennsylvania Philadelphia, Pennsylvania
Departments of Anesthesia and Perioperative Care; Philadelphia, Pennsylvania Anxiety Disorders
Obstetrics, Gynecology and Reproductive Sciences; Atherosclerotic Disease
and Surgery Constipation
Delirium (Postanesthetic)/Dementia
Orlando J. Salinas, MD
University of California, San Francisco Assistant Professor of Anesthesiology
San Francisco, California Louisiana State University Medical Center
Myelomeningocele Marc A. Rozner, PhD, MD New Orleans, Louisiana
Professor Fish Oil
John F. Rompala, MD Department of Anesthesiology and Perioperative
Clinical Anesthesiologist, Portland VA Medical Center Medicine
Department of Cardiology
Jibin V. Samuel, MB, BS, MD
Assistant Professor, Oregon Health Sciences Pediatric Anesthesiologist
University University of Texas MD Anderson Cancer Center All Children’s Hospital
Portland, Oregon Houston, Texas Johns Hopkins Medicine
Bleomycin Sulfate Toxicity Chemotherapeutic Agents St. Petersburg, Florida
Implantable Cardioverter-Defibrillators Diaphragmatic Hernia (Congenital)
Pacemakers
Sydney E. Rose, MD
Regional and Pain Medicine Fellow
Portland, Oregon
xxiv Gaucher Disease
Contributors
Robert Sanders, BSc, MBBS, PhD, David L. Schreibman, MD Kumaran Senthil, MD

FRCA Assistant Professor Anesthesiology Resident
Assistant Professor Department of Anesthesiology Department of Anesthesiology and Critical Care
Department of Anesthesiology University of Maryland School of Medicine Medicine
University of Wisconsin School of Medicine and Baltimore, Maryland University of Pennsylvania School of Medicine
Public Health Encephalitis Philadelphia, Pennsylvania
Madison, Wisconsin Kawasaki Disease
Alpha2 Adrenergic Agonists Thomas Schricker, MD, PhD
Department of Anesthesia Tamas Seres, MD, PhD
Annie Santi, MD Royal Victoria Hospital Associate Professor
Resident Physician McGill University Health Centre Department of Anesthesiology
Department of Anesthesiology and Critical Care Montreal, Canada University of Colorado
Hospital of the University of Pennsylvania Insulin Aurora, Colorado
Philadelphia, Pennsylvania Posttransplant Lymphoproliferative Disorder
Paget Disease Armin Schubert, MD, MBA
Vice President of Medical Affairs Evan Serfass, MD, PhD
Hiroaki Sato, MD, PhD System Chair, Department of Anesthesiology Assistant Professor, Pediatric Anesthesia
Department of Anesthesia Ochsner Medical Center Department of Anesthesiology and Perioperative
Royal Victoria Hospital New Orleans, Louisiana Medicine
McGill University Health Centre Multiple Sclerosis Oregon Health and Science University
Montreal, Canada Portland, Oregon
Insulin Peter M. Schulman, MD Heart Disease, Congenital
Associate Professor
Luis R. Sauceda-Cerda, MD Department of Anesthesiology and Perioperative Daniel I. Sessler, MD
Resident Physician Medicine Michael Cudahy Professor and Chair
Department of Anesthesiology and Perioperative Medicine Oregon Health and Science University Department of Outcomes Research
Oregon Health and Science University Portland, Oregon Cleveland Clinic
Portland, Oregon Acidosis, Lactic/Metabolic Cleveland, Ohio
Amphetamines Implantable Cardioverter-Defibrillators Hypothermia, Mild
Marijuana Pacemakers
Sepsis, Severe Sepsis, and Septic Shock Navil F. Sethna, MD, FAAP
Puneet Sayal, MD, MSc
CONTRIBUTORS
Senior Associate in Anesthesia
Pain Medicine Fellow Alan Jay Schwartz, MD, MSEd Associate Professor of Anesthesiology
University of Texas MD Anderson Cancer Center Director of Education Harvard Medical School
Houston, Texas Department of Anesthesiology and Critical Care Medicine Department of Anesthesiology, Perioperative and Pain
Asthma, Acute The Children’s Hospital of Philadelphia Medicine
Professor of Clinical Anesthesiology and Critical Care Boston Children’s Hospital
Perelman School of Medicine at the University of Boston, Massachusetts
Thomas Schilling, MD, PhD, DEAA Pennsylvania Prader-Willi Syndrome
Clinical Assistant Professor Philadelphia, Pennsylvania
Department of Anesthesiology and Intensive Care
Medicine
Apnea of the Newborn Pranav R. Shah, MD
Otto-von-Guericke-University Magdeburg Assistant Professor
Magdeburg, Germany Jamie McElrath Schwartz, MD Divisions of Cardiac Anesthesiology and Critical Care
Niemann-Pick Disease Attending Physician Medicine
Department of Critical Care Medicine and Virginia Commonwealth University
Anesthesiology Richmond, Virginia
R. Alexander Schlichter, MD Children’s National Medical Center Sick Sinus Syndrome
Associate Professor of Clinical Anesthesiology and Assistant Professor
Critical Care
Chief of Neuroanesthesia, Hospital of the University
Department of Anesthesiology and Pediatrics
George Washington University School of Medicine
Ronak Shah, MD
of Pennsylvania Assistant Professor, Adult Cardiothoracic
Washington, District of Columbia
Chief of Anesthesia for Interventional Radiology, Anesthesiology
Single (Including Common) Ventricle
Hospital of the University of Pennsylvania Department of Anesthesiology and Critical Care
Philadelphia, Pennsylvania Hospital of the University of Pennsylvania
Arnold-Chiari Malformation (Chiari Malformation Type II) John W. Sear, MA, PhD, MBBS, Philadelphia, Pennsylvania
Chiari Malformations FFARCS, FANZCA Myocarditis
Seizures, Epileptic Professor
Nuffield Department of Anaesthetics Jessica L. Shanahan, MD
Eric Schnell, MD, PhD University of Oxford
Oxford, United Kingdom
Director of Preadmission Services
Staff Anesthesiologist Department of Anesthesiology
VA Portland Health Care System VA Boston Healthcare System
Assistant Professor Sankalp Sehgal, MD West Roxbury, Massachusetts
Department of Anesthesiology and Perioperative Attending Anesthesiologist Brain Death
Medicine Department of Anesthesiology
Oregon Health and Science University Division of Cardiothoracic Anesthesiology Ankur Sharma, MBBS, MD, DNB,
Portland, Oregon
Phenothiazines
New York Presbyterian/Weill Cornell Medicine
New York, New York
MNAMS, FCCS
Senior Research Associate
Graves Disease Department of Anesthesia, Critical Care and Pain
Robert B. Schonberger, MD Medicine
Fellow of Cardiothoracic Anesthesia and Clinical Sudipta Sen, MBBS All India Institute of Medical Sciences
Research Assistant Professor Ansari Nagar, India
Department of Anesthesiology Department of Anesthesiology Saethre-Chotzen Syndrome
Yale University School of Medicine Louisiana State University Health Sciences Center
New Haven, Connecticut Shreveport, Louisiana
Aortic Regurgitation S-Adenosyl-L-Methionine xxv
Contributors
Joanne Shay, MD, MBA Ashish C. Sinha, MD, PhD, MBA Janelle B. Snoddy, MD
Assistant Professor Professor Resident Physician
Director of Pediatric Remote Anesthesia Services Department of Anesthesiology Department of Anesthesiology and Critical Care
Pediatric Anesthesiology and Critical Care Medicine Katz School of Medicine Hospital of the University of Pennsylvania
Johns Hopkins University School of Medicine Temple University Philadelphia, Pennsylvania
Baltimore, Maryland Philadelphia, Pennsylvania Spinal Cord Injury
Anemia, Aplastic Cancer, Bladder
Candidiasis
CREST Syndrome
Cobin D. Soelberg, MD, JD, MBe
Stephen J. Shepherd, MBBS, Depression, Unipolar
Assistant Professor
MRCP, FRCA, FFICM Mediastinal Masses
Department of Anesthesia and Perioperative Medicine
Oregon Health and Sciences University
Consultant in Anaesthesia and Intensive Care Morbid Obesity Portland, Oregon
St. Bartholomew’s Hospital
Wilson Disease
London, United Kingdom
Fluoxetine (Prozac) Renu Sinha, MBBS, MD
Professor
Department of Anaesthesiology, Pain Medicine and
Betsy Ellen Soifer, MD, PhD
Veena Sheshadri, MBBS, MD Critical Care
Anesthesiologist
Operative Care Division
Clinical Fellow All India Institute of Medical Sciences Portland Veterans Affairs Medical Center
Department of Anesthesia and Pain Medicine New Delhi, India Associate Professor of Anesthesiology and
University of Toronto Sturge-Weber Syndrome Perioperative Care
Toronto Western Hospital
Toronto, Canada
Seizures, Tonic-Clonic (Grand Mal) Eellan Sivanesan, MD Portland, Oregon
Department of Anesthesiology, Perioperative Medicine Subphrenic Abscess
and Pain Management
Ramchandra Vinayak Shidhaye, University of Miami Amy O. Soleta, MD
MD, DA Miami, Florida Assistant Professor
Professor Bronchiolitis Obliterans Syndrome Anesthesiology and Perioperative Medicine
Department of Anesthesiology Oregon Health and Science University
L.N. Medical College and J.K. Hospital Daniel C. Sizemore, MD Portland, Oregon
Bhopal, India Program Director, Anesthesiology Residency Kava
Rubella and Congenital Rubella Syndrome Vice Chair for Academic Affairs Plagiocephaly
Assistant Professor
CONTRIBUTORS
Jeffrey S. Shiffrin, MD Department of Anesthesiology Molly Solorzano, MD

Associate Professor West Virginia University Instructor
Department of Anesthesiology Morgantown, West Virginia Mayo Clinic Hospital
University of Colorado Herpes, Type I Phoenix, Arizona
Aurora, Colorado Insulinoma
Physostigmine, Eserine Sara M. Skrlin, MD
Staff Anesthesiologist Aris Sophocles, MD
Adam Shomstein, DO, MBA VA Portland Health Care System Department of Anesthesiology
Physical Medicine and Rehabilitation and Portland, Oregon Children’s Hospital
Interventional Pain Hypomagnesemia Denver, Colorado
Louisiana State University Magnesium Sulfate Patent Ductus Arteriosus
Headache, Migraine Kieran A. Slevin, MD Roy G. Soto, MD
Medical Director Residency Program Director and Professor
Daniel Siker, MD North American Spine and Pain Consultants Department of Anesthesiology
Staff Physician Hainesport, New Jersey Beaumont Health System
Department of Pediatrics and Anesthesiology Autonomic Dysreflexia Royal Oak, Michigan
Medical College of Wisconsin Hemosiderosis, Pulmonary
Milwaukee, Wisconsin Tod B. Sloan, MD, MBA, PhD
Cherubism Professor Emeritus
University of Colorado Medical School
Joan Spiegel, MD
Assistant Professor
George Silvay, MD, PhD Aurora, Colorado Department of Anesthesia, Critical Care and Pain
Professor Infratentorial Tumors Medicine
Department of Anesthesiology Supratentorial Brain Tumors Harvard Medical School
Ichan School of Medicine at Mount Sinai Beth Israel Deaconess Medical Center
New York, New York Kathleen A. Smith, MD Boston, Massachusetts
Marfan Syndrome Associate Professor of Anesthesiology Chitosan
University of North Carolina Saw Palmetto
Gyaninder P. Singh, MD, DM Chapel Hill, North Carolina
Associate Professor Cushing Syndrome Raymond D. Sroka, MD, PharmD
Department of Neuroanaesthesiology and Critical Anesthesiologist and Assistant Director
Care Timothy E. Smith, MD Anesthesia Preoperative Evaluation Clinic
Neurosciences Centre, All India Institute of Medical Associate Professor, Pediatric Anesthesiology Department of Anesthesiology
Sciences Wake Forest Baptist Health Roswell Park Cancer Institute
New Delhi, India Winston-Salem, North Carolina Clinical Instructor and Academic Scholar
Transverse Myelitis Hydrocephalus Department of Anesthesia
State University of New York at Buffalo
Buffalo, New York
Alkylating Agents
xxvi
Contributors
Katherine Stammen, MD Jonathan M. Tan, MD, MPH James Joseph Thomas, MD

Assistant Professor of Anesthesiology Assistant Professor Assistant Professor
Assistant Residency Program Director Department of Anesthesiology and Critical Care Children’s Hospital Colorado
Course Director, Medical Student Education Perelman School of Medicine at the University of University of Colorado
Department of Anesthesiology Pennsylvania Aurora, Colorado
Louisiana State University Health Sciences Center The Children’s Hospital of Philadelphia Occipital Encephalocele
Shreveport, Louisiana Philadelphia, Pennsylvania
S-Adenosyl-L-Methionine Craniofacial Clefts Arlyne K. Thung, MD
Clinical Assistant Professor
Stanley W. Stead, MD, MBA Rob Tanzola, MD, FRCPC Nationwide Children’s Hospital
Clinical Professor of Anesthesiology and Perioperative Associate Professor The Ohio State University
Medicine Queen’s University Columbus, Ohio
University of California, Irvine Kingston, Canada Beckwith-Widemann Syndrome
President Churg-Strauss Syndrome Treacher Collins Syndrome
Stead Health Group, Inc.
Los Angeles, California
Blindness
Rayhan A. Tariq, MD Dawn D. Tiemann, MD
Resident Assistant Professor of Clinical Anesthesiology
Department Of Anesthesiology Department of Anesthesiology
John K. Stene, MD, PhD Drexel University College of Medicine Louisiana State University School of Medicine
Professor Philadelphia, Pennsylvania New Orleans, Louisiana
Department of Anesthesiology and Neurosurgery Fanconi Syndrome Nutraceuticals
Penn State Milton S. Hershey Medical Center Procainamide (Procan, Procanbid, Pronestyl)
Hershey, Pennsylvania Vasanti Tilak, MD
Vitamin B12 Carin Tauriello, MD Assistant Professor
Assistant Professor of Anesthesiology Department of Anesthesiology
Nathalie Stevenson, BSc, BM, State University of New York at Buffalo New Jersey Medical School, Rutgers
FRCA, FFICM Staff Anesthesiologist Newark, New Jersey
Consultant Roswell Park Cancer Institute Antithrombin III Deficiency
Intensive Care and Anaesthetics Buffalo, New York
Royal Free London NHS Foundation Trust Bleomycin Joseph R. Tobin, MD
London, United Kingdom Professor Emeritus
Magnus K. Teig, BMedSci (Hons),
CONTRIBUTORS
Ventricular Preexcitation Syndrome Department of Anesthesiology
MBChB, MRCP, FRCA, EDIC, FFICM Wake Forest School of Medicine
Rae Stewart, MD Assistant Professor Winston-Salem, North Carolina
Anesthesiology Resident Hydrocephalus
Department of Anesthesiology University of Michigan
Montefiore Medical Center Ann Arbor, Michigan R. David Todd, MD
New York, New York Cigarette Smoking Interventional Pain Medicine
Colchicine Tennessee Orthopaedic Alliance
René Tempelhoff, MD Nashville, Tennessee
Tracey L. Stierer, MD Professor of Anesthesiology and Neurological Surgery Glossopharyngeal Neuralgia
Assistant Professor of Anesthesiology and Critical Washington University School of Medicine
Care Medicine St Louis, Missouri Brandon M. Togioka, MD
Director of Ambulatory Anesthesia Division Seizures, Intractable Assistant Professor
Johns Hopkins University Anesthesiology and Perioperative Medicine
Baltimore, Maryland
Oral Contraceptives John E. Tetzlaff, MD Oregon Health and Science University
Portland, Oregon
Hemochromatosis
Cleveland Clinic Lerner College of Medicine of Case
David F. Stowe, MD, PhD Western Reserve University Pemphigus
Professor of Anesthesiology and Physiology Cleveland, Ohio
Medical College of Wisconsin Ankylosing Spondylitis De Q.H. Tran, MD, FRCPC
Adjunct Professor of Biomedical Engineering Degenerative Disk Disease Professor
Marquette University Montreal General Hospital
Senior Staff Anesthesiologist
Zablocki Veterans Medical Center Marie A. Theard, MD Department of Anesthesia
McGill University
Milwaukee, Wisconsin Assistant Professor
Montreal, Canada
Serotonin: Agonists, Antagonists, and Reuptake Inhibitors Department of Anesthesiology
Bisphosphonates
Washington University School of Medicine
St. Louis, Missouri
Erin A. Sullivan, MD Scoliosis and Kyphosis Kha M. Tran, MD
Associate Professor of Anesthesiology and Critical Associate Professor of Clinical Anesthesiology and
Care Medicine
Department of Anesthesiology Jacob Addison Thomas, MD Critical Care Medicine
University of Pittsburgh School of Medicine Resident Anesthesiologist
Pennsylvania
Pittsburgh, Pennsylvania Department of Anesthesiology and Critical Care
Attending Anesthesiologist
Sick Sinus Syndrome University of Pennsylvania
Director, Fetal Anesthesia Services
Medical Director, Bucks County Ambulatory Surgical
Associate Anesthesiologist
Dajin Sun, MD Department of Anesthesia Facility
Professor Emeritus The Children’s Hospital of Philadelphia
University of Iowa
Department of Anesthesiology Philadelphia, Pennsylvania
Iowa City, Iowa
School of Medicine at Jiaotong University Bilirubinemia of the Newborn
Monoamine Oxidase Inhibitors; Reversible Inhibitors of
Shanghai, China Monoamine Oxidase
Carnitine
xxvii
Contributors
Lien Tran, MD Shital Vachhani, MD Surbhi Virmani, MD, LLB

Assistant Professor Anesthesiologist Specialist Registrar
Louisiana State University School of Medicine University of Texas MD Anderson Cancer Center National Hospital for Neurology and Neurosurgery
New Orleans, Louisiana Houston, Texas London, United Kingdom
Hypermagnesemia Implantable Cardioverter-Defibrillators Creutzfeldt-Jakob Disease
Lipidemias
Marissa G. Vadi, MD, MPH Alexander A. Vitin, MD, PhD
Minh Chau Joe Tran, MD, MPH Assistant Professor of Anesthesiology Associate Professor
Pediatric Anesthesiologist Loma Linda University School of Medicine Department of Anesthesiology
Loma Linda University Medical Center Loma Linda, California University of Washington
Loma Linda VA Medical Center Bronchopulmonary Dysplasia Seattle, Washington
Just Oral Boards, LLC Silicosis
Loma Linda, California Ashley R. Valentine, MD, PhD
Achondroplasia, Dwarfism Resident Physician Marian E. Von-Maszewski, MD
Department of Anesthesia and Perioperative Medicine Assistant Professor
Erin Treasy, MD Oregon Health and Science University Department of Critical Care
Assistant Professor of Anesthesiology Portland, Oregon University of Texas MD Anderson Cancer Center
Department of Anesthesiology and Perioperative De Morsier Syndrome Houston, Texas
Medicine Gastrinoma Cardiomyopathy, Alcoholic
Drexel University College of Medicine
Hahnemann University Hospital
Elizabeth A. Valentine, MD Varuna Vyas, MBBS, MD
Assistant Professor Senior Resident
Calcium Deficiency/Hypocalcemia Department of Anesthesiology and Critical Care Department of Pediatrics
Perelman School of Medicine at the University of All India Institute of Medical Sciences
Kevin K. Tremper, PhD, MD Pennsylvania Ansari Nagar, India
Professor and Chair Philadelphia, Pennsylvania Saethre-Chotzen Syndrome
Department of Anesthesiology Peripheral Vascular Disease
University of Michigan Suchin R. Wadhwani, MD
Ann Arbor, Michigan
Cigarette Smoking
Manuel C. Vallejo, MD, DMD Anesthesiology Resident
Designated Institutional Official Department of Anesthesiology and Critical Care
Assistant Dean University of Pennsylvania
January Y. Tsai, MD
CONTRIBUTORS
Professor of Medical Education, Anesthesiology, and Philadelphia, Pennsylvania

Anesthesiologist Obstetrics and Gynecology Urinary Lithiasis
University of Texas MD Anderson Cancer Center West Virginia University School of Medicine
Houston, Texas
Pacemakers
Herpes, Type I
K. Karisa Walker, MD
Acting Assistant Professor
Rifampin Department of Anesthesiology and Pain Medicine
Lawrence C. Tsen, MD University of Washington School of Medicine
Associate Director Luke Van Alstine, MD Seattle Children’s Hospital
Center for Professionalism and Peer Support Instructor of Anesthesiology Seattle, Washington
Director of Anesthesia Mayo Clinic Jeune Syndrome (Asphyxiating Thoracic Dystrophy)
Center for Reproductive Medicine Rochester, Minnesota
Medicine
Poliomyelitis Russell T. Wall III, MD
Chair, Department of Anesthesiology
Brigham and Women’s Hospital
Associate Professor in Anaesthesia
Albert J. Varon, MD, MHPE, FCCM Medstar Georgetown University Hospital
Miller Professor and Vice Chair for Education Professor, Anesthesiology & Pharmacology
Harvard Medical School Department of Anesthesiology Georgetown University School of Medicine
Boston, Massachusetts University of Miami Miller School of Medicine Washington, District of Columbia
Pregnancy, Ectopic Miami, Florida Acromegaly
Burn Injury, Chemical Anorexia Nervosa
Kenneth J. Tuman, MD Burn Injury, Electrical
Professor and Chair
Burn Injury, Flame Jason D. Walls, MD
Assistant Professor
Rush University Medical Center
Chicago, Illinois
Lashmi Venkatraghavan, MBBS, Department of Anesthesiology and Critical Care
Phenylephrine (Neo-Synephrine) MD, DNB, FRCA, FRCPC Hospital of the University of Pennsylvania
Associate Professor Philadelphia, Pennsylvania
Ventricular Tachycardia
University of Toronto Arnold-Chiari Malformation (Chiari Malformation Type II)
Toronto Western Hospital Chiari Malformations
Mark Twite, MA, MB, BChir, FRCP Toronto, Canada Hypoparathyroidism
Director Occlusive Cerebrovascular Disease
Pediatric Cardiac Anesthesia
Seizures, Absence (Petit Mal) Brendan T. Wanta, MD
Seizures, Tomic-Clonic (Grand Mal) Assistant Professor of Anesthesiology
Children’s Hospital and University of Colorado Mayo Clinic
Denver, Colorado
Patent Ductus Arteriosus Francis Veyckemans, MD Rochester, Minnesota
Anesthesiologist Endocarditis
Department of Pediatric Anesthesia
Alexander Tzabazis, MD Hôpital Jeanne de Flandre Lucy Waskell, MD, PhD
Clinical Assistant Professor CHRU de Lille Professor of Anesthesia
Department of Anesthesiology, Perioperative and Pain Lille, France University of Michigan Medical School
Medicine Landouzy-Dejerine Dystrophy (Facioscapulohumeral Director, Anesthesia Research
Stanford University School of Medicine Muscular Dystrophy) Department of Anesthesiology
Stanford, California Veterans Affairs Medical Center
Narcolepsy Ann Arbor, Michigan
xxviii Penicillins
Contributors
Scott C. Watkins, MD John O.R. Whittle, FRCA Man Piu Wong, MD

Assistant Professor Locum Consultant Anaesthesia ACCM Fellow
Department of Anesthesiology Royal Free Hospital New York Presbyterian–Columbia University Medical
Division of Pediatric Cardiac Anesthesiology Honorary Clinical Lecturer in Perioperative Medicine Center
Monroe Carell Jr. Children’s Hospital at Vanderbilt University College New York, New York
University Medical Center London, United Kingdom Hepatic Encephalopathy
Nashville, Tennessee Ventricular Tachyarrhythmias
Alcohol Abuse Zerlina Wong, MD
Duminda N. Wijeysundera, MD, Critical Care Fellow
Menachem M. Weiner, MD PhD, FRCPC Anesthesiology and Perioperative Medicine
Associate Professor Associate Professor of Anesthesia Oregon Health and Science University
Department of Anesthesiology University of Toronto Portland, Oregon
Icahn School of Medicine at Mount Sinai Toronto, Canada Multiple Organ Dysfunction Syndrome
New York, New York Beta-Adrenergic Receptor Antagonists (Blockers)
Ventricular Septal Defect (Congenital)
Ventricular Septal Rupture (Defect), Postmyocardial
Calcium-Channel Blockers Anthony K. Woodall, MD
Senior Resident
Infarction
Danny Wilkerson, MD Department of Anesthesiology
Professor Louisiana State University Health Sciences Center
Toby N. Weingarten, MD Departments of Anesthesiology and Obstetrics and New Orleans, Louisiana
Professor of Anesthesiology Gynecology Hepatitis, Alcoholic
Department of Anesthesia and Perioperative Medicine College of Medicine
Mayo Clinic
Rochester, Minnesota
University of Arkansas for Medical Sciences Patrick F. Wouters, MD, PhD
Little Rock, Arkansas Department Chair
Amyloidosis Diabetes, Type III (Gestational Diabetes Mellitus) Anesthesia and Perioperative Medicine
Ghent University Hospital
Mitchell L. Weinstein, MD Nancy C. Wilkes, MD Ghent, Belgium
Assistant Professor of Clinical Anesthesiology and Professor of Anesthesiology Alpha1 Antagonists
Critical Care Medicine Medical Director, Ambulatory Surgery Center
University of Pennsylvania
Chief of Neuroanesthesia
Co-Division Chief, Ambulatory Anesthesia Melville Q. Wyche III, MD
University of North Carolina Hospitals Assistant Professor of Clinical Anesthesiology
Penn Presbyterian Medical Center Chapel Hill, North Carolina Department of Anesthesiology
CONTRIBUTORS
Diverticulosis Louisiana State University School of Medicine
Brain Injury, Traumatic Kartagener Syndrome New Orleans, Louisiana
Vitamin D Deficiency Hepatitis, Alcoholic
Mark S. Weiss, MD
Assistant Professor Glyn D. Williams, MBChB, FFA David A. Wyler, MD
Department of Anesthesiology and Critical Care Professor Assistant Professor
Perelman School of Medicine at the University of Department of Anesthesiology, Perioperative and Pain Departments of Anesthesiology and Neurological
Pennsylvania Medicine Surgery
Philadelphia, Pennsylvania Stanford University Division of Critical Care
Proton Pump Inhibitors Palo Alto, California Jefferson Hospital for Neuroscience
Rheumatic Fever (Acute) and Rheumatic Heart Disease Dextrocardia Thomas Jefferson University
Charles Weissman, MD Sylvia H. Wilson, MD Huntington Disease
Professor and Chair Associate Professor
Medicine
Department of Anesthesia and Perioperative Medicine Miguel A. Yaport, MD
Medical University of South Carolina Anesthesiology Resident
Hadassah-Hebrew University Medical Center Charleston, South Carolina University of Pennsylvania Health System
Hebrew University, Hadassah School of Medicine Charcot-Marie-Tooth Disease Philadelphia, Pennsylvania
Jerusalem, Israel Addison Disease
Encephalopathy, Metabolic
Encephalopathy, Postanoxic Jimmy Windsor, MD Bernard-Soulier Syndrome
Protein C Deficiency Director of Pediatric Cardiac Anesthesiology
Department of Anesthesiology and Critical Care Carl Ying, MD
University of New Mexico School of Medicine Anesthesia
Megan K. Werntz, MD Albuquerque, New Mexico Loma Linda University Medical Center
Anesthesiology Resident Tricuspid Atresia Loma Linda, California
Department of Anesthesiology and Perioperative Achondroplasia, Dwarfism
Medicine
Oregon Health and Science University Gregory A. Wolff, BS, MD
Portland, Oregon Resident Physician Jeongae Yoon, MD
Hemochromatosis Department of Anesthesiology Adult Cardiothoracic Anesthesia Fellow
Pemphigus University of Colorado Department of Anesthesiology and Critical Care
Aurora, Colorado Hospital of the University of Pennsylvania
Cromolyn Sodium Philadelphia, Pennsylvania
Gina Whitney, MD Buerger Disease (Thromboangiitis Obliterans)
Assistant Professor of Anesthesiology and Pediatrics
Pediatric Anesthesiology and Pediatric Intensive Care Michael Wollenberg, MD
Vanderbilt Children’s Hospital Assistant Professor
Vanderbilt University Medical Center Department of Anesthesiology and Perioperative
Nashville, Tennessee Medicine
Supraventricular Tachycardia (Tachyarrhythmias) Oregon Health and Science University
Portland, Oregon
Pulmonary Hypertension
xxix
Contributors
Francine S. Yudkowitz, MD, FAAP Paul Zanaboni, MD, PhD Elizabeth Y. Zhou, MD
Professor of Anesthesiology, Perioperative and Pain Associate Professor Assistant Professor
Medicine, and Pediatrics Department of Anesthesiology Adult Cardiothoracic Anesthesiology
Icahn School of Medicine at Mount Sinai Washington University School of Medicine Hospital of the University of Pennsylvania
Director, Pediatric Anesthesia St. Louis, Missouri Philadelphia, Pennsylvania
The Mount Sinai Hospital Cor Pulmonale Pericarditis, Constrictive
New York, New York
Congenital Pulmonary Lesions/Lobar Emphysema
Gastroesophageal Reflux in Children
Warren M. Zapol, MD Maurice S. Zwass, MD
Reginald Jenney Professor of Anaesthesia Professor of Anesthesia and Pediatrics
Moyamoya Department of Anesthesia Anesthesia and Perioperative Care
Massachusetts General Hospital University of California San Francisco
James R. Zaidan, MD, MBA Boston, Massachusetts San Francisco, California
Professor of Anesthesiology Nitric Oxide, Inhaled Croup (Laryngotracheobronchitis)
Department of Anesthesiology Epiglottitis
Associate Dean for GME
Emory University School of Medicine
Atlanta, Georgia
Mobitz I (Second-Degree Atrioventricular Block)
Mobitz II (Second-Degree Atrioventricular Block)
CONTRIBUTORS
xxx
Preface
It has been 6 years since the last edition of Essence of Anesthesia Practice was published and
2 decades since the first edition. The goal of this text was, and continues to be, to provide a
concise summary that allows you to act for your patient with more complete knowledge of the
pathophysiology of both common and rare conditions seen in the perioperative period as well
as the medications used to treat these conditions. We have eliminated the summaries for surgi-
cal procedures in favor of more rare diseases as well as general drugs that patients take on an
outpatient basis.
These summaries are structured in a defined way to enable you to focus on the key facts and
issues as well as the anticipated concerns regarding these conditions and medications in order
that you, the anesthesiologists, can function as perioperative physicians and provide optimal care
of the patient. We have done PubMed and Google searches, selected key references, read the
articles and case reports, and boiled the hours of reading into 10 minutes of summary with all
the key points highlighted. Treatments, including medications for chronic conditions, continue
to evolve, and it is difficult to keep up with the perioperative implications and appropriate pre-
operative evaluation without this effort. We also felt that in previous editions we did not include
as many uncommon conditions as we would like and as you wanted. We therefore enrolled more
than 500 authors, some of whom wrote the original chapters and many of whom are new, and
have either updated the original chapters or added new topics to address these concerns in the
fourth edition of Essence of Anesthesia Practice.
PREFACE
This edition continues to improve and update the material that went before and to add the
most up-to-date topics and new medications. We continue to include a large section on herbal
medications given their popularity and common use by our surgical patients. We believe that the
current format lends itself to quick review and orientation of the practitioner to perioperative
implications at the point of care.
We wish to thank the authors of the previous edition upon which many of the new authors
produced revised chapters. We also thank Dolores Meloni, our Executive Content Strategist at
Elsevier, and Rae Robertson, our Senior Content Development Specialist, for ensuring that our
book received appropriate editing and development as well as providing the relentless support
for this text to be published in a timely manner.
Lee A. Fleisher, MD
Michael F. Roizen, MD
Jeffrey D. Roizen, MD, PhD
xxxi
Abbreviations
SYMBOLS ALS amyotrophic lateral sclerosis BOOP bronchiolitis obliterans with
± plus or minus ALT alanine aminotransferase cryptogenic organizing
? questionable Alv alveolar pneumonia
∼ approximately am morning BOS bronchiolitis obliterans syndrome
° C degrees centigrade AML acute myelogenous leukemia BP blood pressure
° F degrees Fahrenheit AMP adenosine monophosphate BPD bronchopulmonary dysplasia
1° primary; first degree ampl amplitude BPEG British Pacing and
2° secondary; second degree ANA antinuclear antibody Electrophysiology Group
3° third degree angio angiogram BPH benign prostatic hyperplasia/
ΔΔ delta gap ANS autonomic nervous system hypertrophy
ant anterior bpm beats per minute
A anticoag anticoagulation BPP biophysical profile
A-a alveolar-arterial AOM acute otitis media BRBPR bright red blood per rectum
AA arachidonic acid AP accessory pathway; action BS breath sounds
AAA abdominal aortic aneurysm potential; anteriorposterior BSA body surface area
A-aDO2 alveolar-arterial oxygen delivery APC activated protein C BT bleeding time; Blalock-Taussig
AAT alpha1-antitrypsin; automatic API alkaline protease inhibitor (shunt)
atrial tachycardia approx approximate; approximately BUN blood urea nitrogen
AAP American Academy of Pediatrics APTT activated partial thromboplastin BWS Beckwith-Wiedemann
abd abdomen; abdominal time syndrome
ABG arterial blood gas AR aortic regurgitation Bx biopsy
ABI aorto-bi-iliac bypass ARB angiotensin receptor BZD benzodiazepine
abd abdominal blocker
abn abnormal; abnormality ARDS acute respiratory distress C
ACE angiotensin-converting enzyme syndrome CA cancer, cold agglutinins
ACEI angiotensin-converting enzyme ARF acute renal failure ca. about (circa)
inhibitor art arterial Ca2+ calcium
ACG angle-closure glaucoma AS aortic stenosis CAB coronary artery bypass
Ach acetylcholine ASA acetylsalicylic acid; Adams- CABG coronary artery bypass graft
AChE acetylcholinesterase Stokes attack; American CACT carnitine-acylcarnitine
ACIP Advisory Committee on Society of Anesthesiologists translocase
Immunization Practices ASAP as soon as possible CAD coronary artery disease
ACL anterior cruciate ligament ASCVD atherosclerotic cardiovascular cAMP cyclic adenosine
ABBREVIATIONS
ACLS advanced cardiac life support disease monophosphate
ACOG American Congress of ASD atrial septal defect Cao2 arterial oxygen concentration
Obstetricians and ASRA American Society of Regional cardiopulm cardiopulmonary
Gynecologists Anesthesia CAS coronary artery spasm
ACS acute confusional state assoc associated CASS Coronary Artery Surgery Study
ACT activated clotting/coagulation AST aspartate aminotransferase CATCH 22 cardiac defect, abnormal facies,
time AT antithrombin thymic hypoplasia, cleft
ACTH adrenocorticotropic AT1 angiotensin receptor 1 palate, and hypocalcemia
ADEM acute disseminated ATG anti-thymus globulin (syndrome)
encephalomyelitis ATN acute tubular necrosis cath catheter; catheterization
ADH antidiuretic hormone ATP adenosine triphosphate; CBC complete blood count
ADHD attention-deficit hyperactivity antitachycardia pacing CBF cerebral blood flow
disorder Au gold CBG capillary blood glucose
ADI atlas-dens interval AV atrioventricular CBV cerebral blood volume
ADL activities of daily living AVB atrioventricular block CCAM congenital cystic adenomatoid
admin administration; administered AVM arteriovenous malformation malformation
ADP adenosine diphosphate AVR aortic valve replacement CCB calcium-channel blocker
AE alveolar echinococcus CCNU nitrosourea (lomustine)
AED automated external defibrillator B CD4 antigenic marker on helper/
AFE amniotic fluid embolism β-hCG beta human chorionic inducer T cells
AFIB atrial fibrillation gonadotropin CD4+ presence of CD4
AFLT atrial flutter BAER brainstem auditory evoked CDC Centers for Disease Control and
AFP alpha-fetoprotein response Prevention
AG anion gap BAL bronchoalveolar lavage CEA carotid endarterectomy
AH autonomic hyperreflexia BBB bundle branch block; blood- cGMP cyclic guanosine
AHQR Agency for Healthcare Research brain barrier monophosphate
and Quality BCI blunt cardiac injury C-GSF granulocyte colony-stimulating
AI aortic insufficiency BCNU nitrosourea (carmustine) factor
AICD automatic implantable BD Behçet disease CHARGE coloboma, congenital heart
cardioverter defibrillator BF bifascicular; blood flow defects, choanal atresia,
AIDS acquired immunodeficiency bid twice per day retardation of growth and/or
syndrome BIG botulism immune globulin other development, genital
AIH anesthetic-induced hepatitis bilat bilateral anomalies, and ear anomalies
AIM anesthetic-induced BIS bispectral index with deafness
myodystrophy BLS basic life support CHB complete heart block
AIP acute intermittent porphyria BLT bleomycin sulfate toxicity CHCT caffeine halothane contracture
AKA above-knee amputation; also BM bowel movement test
known as BMI body mass index CHD congenital heart disease;
AKI acute kidney injury BMP basic metabolic panel congenital heart defect
AKIN Acute Kidney Injury Network BMR basal metabolic rate ChE cholinesterase
ALA δ-aminolaevulinic acid
BMS bare metal stent CHF congestive heart failure
alb albumin BMT bone marrow transplantation CHO carbohydrate
alk phos alkaline phosphatase BMV bag mask ventilation CHTN congenital hypertension
A-line arterial line BNP brain natriuretic CI cardiac index; confidence
ALL acute lymphoblastic leukemia BO bronchiolitis obliterans interval xxxvii
Abbreviations
CIED cardiac implantable electronic CTX cyclophosphamide (Cytoxan) Dx diagnosis; diagnostic

device CV cardiovascular DXA dual-energy x-ray absorptiometry
CIN cervical intraepithelial neoplasia CVA cerebrovascular accident
circ circulation; circulatory CVC central venous catheter E
CJD Creutzfeldt-Jakob disease CVD cerebrovascular disease EACA epsilon-aminocaproic
CK creatine kinase CVL central venous line EBL estimated blood loss
CKD chronic kidney disease CVP central venous pressure EBT external beam therapy
CK-MB isoenzyme of creatine kinase CVS cardiovascular status EBV Epstein-Barr virus
with muscle and brain subunits CVHH continuous veno-venous EC eclampsia
CLL chronic lymphocytic leukemia hemofiltration ECA ethacrynic acid
cLQTS congenital long QT syndrome CXR chest x-ray ECC extracorporeal circulation
CLR chlorambucil CYP cytochrome P450 ECD endocardial cushion defect
CML chronic myelogenous leukemia cysto cystoscopy ECF extracellular fluid
CMP comprehensive metabolic panel ECFV extracellular fluid volume
CMRO2 cerebral metabolic rate of oxygen D ECG electrocardiogram
CMS Centers for Medicare and 2,3-DPG 2,3-diphosphoglyceric acid ECHO echocardiogram
Medicaid Services 2D two-dimensional ECMO extracorporeal membrane
CMT Charcot-Marie-Tooth disease d day oxygenation
CMV cytomegalovirus D&A drug(s) and alcohol ECoG electrocorticography
CMZ carbamazepine D and T diphtheria and tetanus ECT electroconvulsive therapy
CN cranial nerve; cyanide D/C discontinue(d) ED50 median effective dose
CNH central neurogenic D5 dextrose 5% in water EDAS encephalodural
hyperventilation DA dopamine arteriosynangiosis
CNS central nervous system DBP diastolic blood pressure EDTA ethylenediaminetetraacetic acid
CO carbon monoxide; cardiac output DC direct current EDV end-diastolic volume
CO2 carbon dioxide DCM dilated cardiomyopathy EEC ectrodactyly-ectodermal
coag coagulation DDAVP 1-deamino(8-d-arginine) dysplasia, cleft (syndrome)
COHb carboxyhemoglobin vasopressin; desmopressin EEG electroencephalogram
COM chronic otitis media acetate EENT eyes, ears, nose, throat
COMT catechol-o-methyltransferase DDT dichlorodiphenyltrichloroethane EF ejection fraction
conc concentration DEA Drug Enforcement Agency EGD esophagogastroduodenoscopy
COPD chronic obstructive pulmonary DEB dystrophic epidermolysis E-L Eaton-Lambert
disease bullosa ELBW extremely low birth weight
ABBREVIATIONS
COX cyclooxygenase dec decleration(s) ELISA enzyme-linked immunosorbent

COX-2 cyclooxygenase-2 deriv derivative(s) assay
cP centipoise derm dermatology EMD electromechanical dissociation
CP cerebellopontine (angle); DEXA dual-energy x-ray EMG electromyography
cerebral palsy; constrictive absorptiometry EMI electromagnetic interference;
pericarditis DFA direct immunofluorescent assay electromechanical
CPAP continuous positive airway DFT defibrillation threshold interference
pressure DGL deglycyrrhized licorice EMLA eutectic mixture of local
CPB cardiopulmonary bypass DGLA dihomo-γ-linolenic acid anesthetics
CPD cephalopelvic disproportion DHA docosahexaenoic acid endo endocrine
CPEO chronic progressive external DHEA dehydroepiandrosterone ENT ear, nose, and throat
ophthalmoplegia DHT dihydrotestosterone EP electrophysiologic
CPK creatine phosphokinase DI diabetes insipidus EPA eicosapentaenoic acid
CPM central pontine myelinolysis DIC disseminated intravascular EPI epinephrine
CPN central pontine myelinolysis coagulation EPO evening primrose oil
CPP cerebral perfusion pressure diff differential EPS electrophysiologic study;
CPR cardiopulmonary resuscitation Dig digoxin extrapyramidal side effects
CPT carnitine palmityl transferase DKA diabetic ketoacidosis ER emergency room
Cr creatinine DKS Damus–Kaye–Stansel ERCP endoscopic retrograde
CRAO central retinal artery occlusion (procedure) cholangiopancreatography
CrCl creatinine clearance DLB dementia with Lewy bodies ERV expiratory reserve volume
CREST calcinosis, Raynaud DLco carbon monoxide diffusion ES Eisenmenger syndrome
phenomenon, esophageal capacity in the lungs es estimated
dysmotility, sclerodactyly, DLT double lumen endotracheal tube ESLD end-stage liver disease
and telangiectasia DM diabetes mellitus ESM ethosuximide
CRF cancer-related fatigue DMARD disease-modifying antirheumatic esp especially
CRI chronic renal insufficiency drug ESR erythrocyte sedimentation rate
CRP c-reactive protein DMD Duchenne muscular dystrophy ESRD end-stage renal disease
CRPS complex regional pain syndrome DMR depolarizing muscle relaxant ESS endoscopic sinus surgery
CRS congenital rubella syndrome DMSO dimethylsufoxide ESU electrosurgery
CRRT continuous renal replacement DNA deoxyribonucleic acid ESV end-systolic volume
therapy DNR do not resuscitate ESWL extracorporeal shock wave
CRT cardiac resynchronization DOB dobutamine lithotripsy
therapy DOE dyspnea on exertion ET endotracheal
cryo cryoprecipitate DPI dry powder inhaler ETCO2 end-tidal carbon dioxide
CS chondroitin sulfate DPNB dorsal penile nerve block ETD eustachian tube dysfunction
C-section cesarean section dSSEP dermatomal somatosensory ETN2 end-tidal nitrogen
CSE combined spinal epidural evoked potentials ETOH ethanol
CSF cerebrospinal fluid DTIC dimethyltriazenoimidazole ETT endotracheal tube; exercise
CSH carotid sinus hypersensitivity carboxamide (dacarbazine) tolerance test
CSM carotid sinus massage DTPA diethylenetriaminepenta-acetic eval evaluation
C-spine cervical spine acid EVD external ventricular drain
CSS carotid sinus syndrome DTR deep tendon reflex Ex exercise
CT computed tomography; DTs delirium tremens exam examination
xxxviii connective tissue DVT deep vein thrombosis ext exterior
Abbreviations
F GI gastrointestinal HRCT high-resolution computed

5-FU 5-fluorouracil GLA γ-linolenic acid
tomography
F female(s) glu glucose HSAN hereditary and sensory
Fab fragment, antigen-binding GPi globus pallidus autonomic neuropathy
FAD flavin adenine dinucleotide GPN glossopharyngeal neuralgia HSCR Hirschsprung disease
FAO Food and Agriculture GTP guanosine triphosphate HSP Henoch-Schönlein purpura
Organization of the United GTT glucose tolerance test HSV herpes simplex virus
Nations GU genitourinary HSV-1 HSV type 1
FB foreign body GVHD graft versus host disease HSV-2 HSV type 2
FBC full blood count gyn gynecologic ht height
FBS fasting blood sugar Htn/HTN hypertension
FDA Food and Drug Administration H HUS hemolytic uremic syndrome
FDP fibrin-degradation product 5-HIAA 5-hydroxyindoleacetic acid HVPG hepatic venous pressure gradient
Fe iron 5-HT 5-hydroxytryptamine Hx history
Fe2+ ferrous H&N head and neck
Fe3+ ferric H&P history and physical I
FEES fiberoptic endoscopic evaluation H1 histamine receptor type 1 I&D incision and drainage
of swallowing H2 histamine receptor type 2 I/O intake-output
FEIBA factor eight inhibitor bypassing H2O water IABP intra-aortic balloon pump
activity HAART highly active antiretroviral IADH inappropriate antidiuretic
FEN fluids, electrolytes, and therapy hormone
nutrition HAF-PCM hypoalbuminemic form of IBD inflammatory bowel disease
FENa excreted fraction of filtered protein-calorie malnutrition IBS irritable bowel syndrome
sodium HAV hepatitis A virus IBW ideal body weight
FES fat embolism syndrome HB heart block ICA internal carotid artery
FEV forced expiratory volume Hb Hemoglobin ICD implantable cardioverter
FEV1 forced expiratory volume in 1 HbA1c glycosylated hemoglobin defibrillator
second HbM hemoglobin Milwaukee ICF intracellular fluid
FFA free fatty acid HbO2 oxyhemoglobin ICH intracranial hypertension
FFP fresh frozen plasma HBV hepatitis B virus ICP intracranial pressure
FHR fetal heart rate HCG or hCG human gonadotropic hormone ICU intensive care unit
FGF fibroblast growth factor HCM hypertrophic cardiomyopathy ID infectious disease
FGFR fibroblast growth factor HCN hydrogen cyanide IDDM insulin-dependent diabetes
ABBREVIATIONS
receptor Hct hematocrit mellitus
FIO2 fractional inspired oxygen HCTZ hydrochlorothiazide IDL intermediate-density lipoprotein
FIX factor IX HCV hepatitis C virus I:E inspiratory:expiratory ratio
FLAIR fluid-attenuated inversion HD heart disease; Hodgkin’s disease IFN interferon
recovery HDL high-density lipoprotein Ig immunoglobulin
FMTC familial medullary thyroid HDL-C HDL cholesterol IgA immunoglobulin A
carcinoma HDU high dependency unit IgE immunoglobulin E
FNA fine-needle aspiration HDV hepatitis D virus IgG immunoglobulin G
FOB fiberoptic bronchoscopy He helium IGF insulin-like growth factor
FOI fiber optic intubation HEENT head, eyes, ears, nose, throat IGF-I insulin-like growth factor I
FRC functional residual capacity HELLP hemolysis, elevated liver IgM immunoglobulin M
freq frequent; frequency enzymes, and low platelet IHD intermittent hemodialysis;
FS Fanconi syndrome count (syndrome) ischemic heart disease
FSBG fingerstick blood glucose heme hematology IL interleukin
FSH follicle-stimulating hormone HEPAT hepatic IM intramuscular
FSP fibrin split products HEV hepatitis E virus immuno immunologic
FT4E free thyroxine estimate HF heart failure in inch
FTT failure to thrive HFM hemifacial microsomia incl including
FVC forced vital capacity HFOV high-frequency oscillatory inf inferior
FVIII factor VIII ventilation info information
FVL factor V Leiden Hg mercury INFOSAN International Food Safeties
Hgb hemoglobin Authorities Network
G HGPRT hypoxanthine-guanine- INH isoniazid
G gauge phosphoribosyltransferase inj injection
G6PD glucose-6 phosphate HHS hyperglycemic hyperosmolar state INR international normalized ratio
dehydrogenase HHT hereditary hemorrhagic insp inspiratory
GA general anesthesia telangiectasia intox intoxication
GABA gamma-aminobutyric acid HHV-3-6 human herpes viruses intraop intraoperative
GAG glycosaminoglycan HIV human immunodeficiency virus IOL intraocular lens
GBE Ginkgo biloba extract
HLA human leukocyte antigen ION ischemic optic neuropathy
GBL gamma butyrolactone HLHS hypoplastic left heart syndrome IOP intraocular pressure
GBM glomerular basement membrane HMG CoA 3-hydroxy-3-methylglutaryl IP impedance plethysmography;
GCS Glasgow coma scale HMPV human metapneumovirus intraperitoneal;
G-CSF granulocyte colony-stimulating HMSN hereditary motor and sensory intraperitoneally
factor neuropathy IPPB intermittent positive pressure
GDM gestational diabetes mellitus HN2 nitrogen mustard breathing
GE gastroesophageal HNP hernia nuclei pulposi IPF idiopathic pulmonary fibrosis
GER gastroesophageal reflux h/o or H/O history of IPL intense pulsed light
GERD gastroesophageal reflux hosp hospitalization IPPV intermittent positive pressure
disease HPA hypothalamic-pituitary-adrenal ventilation
GFR glomerular filtration rate HPS hepatopulmonary syndrome iPTH intact parathyroid hormone
GGT gamma glutamyltransferase HPV hypoxic pulmonary IQ intelligence quotient
GH growth hormone vasoconstriction ITP immune thrombocytopenic
GHB gamma hydroxybutyrate h or hr hour(s) purpura
Gi inhibitory G protein HR heart rate IUGR intrauterine growth restriction xxxix
Abbreviations
IV intravenous M ms milliseconds
IVC inferior vena cava M male(s) MSK musculoskeletal
IVDU intravenous drug user M:F male to female ratio MSSA methicillin-sensitive
IVF intravascular fluid; intravenous M2 muscarinic Staphylococcus aureus
fluid MAC minimum alveolar MTTP microsomal triglyceride transfer
IVP intravenous pyelogram concentration; monitored protein
anesthesia care MTX methotrexate
J MACE minor adverse cardiac event MU million units
JEB junctional epidermolysis MAHA microangiopathic hemolytic mucocut mucocutaneous
bullosa anemia MUGA multiple gated acquisition
JGA juxtaglomerular apparatus MALA metformin-associated lactic musc muscular
JNC Joint National Committee acidosis MV mitral valve
JV jugular vein MAO monoamine oxidase MVA motor vehicle accident
JVD jugular venous distention MAOI monoamine oxidase inhibitor MVD microvascular decompression
JVP jugular venous pressure MAP mean arterial pressure MVP mitral valve prolapse
MAST medical antishock trousers MW molecular weight
K MAT multiform atrial tachycardia MYL Myleran (busulfan)
K+ potassium max maximum; maximal
KS Kartagener syndrome MBC maximal breathing capacity N
KSS Kearns-Sayre syndrome MC myotonia congenita N nitrogen
KUB kidney, ureter, and bladder MCV mean corpuscular volume n. nerve
MD muscular dystrophy N/A not applicable
L MDI metered-dose inhaler N/V nausea/vomiting
L left MEA multiple endocrine adenomas N2O dinitrogen monoxide (nitrous
LA left atrial; left atrium; linoleic mech mechanical; mechanism oxide)
acid; local anesthetic med medication Na+ sodium
lab laboratory MELAS mitochondrial NAAT nucleic acid amplification test
LAD left anterior descending encephalomyopathy, lactic NAC
N-acetyl-l-cysteine
(coronary artery) acidosis, and stroke-like NADH nicotinamide adenine
LAFB left anterior fascicular block symptoms dinucleotide reduced form
LAP left atrial pressure MEN multiple endocrine neoplasia NADPH nicotinamide adenine
lat lateral MEN I multiple endocrine neoplasia dinucleotide phosphate,
LBBB left bundle branch block type I reduced form
ABBREVIATIONS
LBM lean body mass MEN II multiple endocrine neoplasia NAPA N-acetyl procainamide

LCAT lecithin-cholesterol type II NASH non-alcoholic steatohepatitis
acyltransderase MEP motor/multimodality evoked naso nasograstric
LCH Langerhans cell histiocytosis potential NASPE North American Society of
LDH lactate dehydrogenase MERRF myoclonic epilepsy with ragged Pacing and Electrophysiology
LDL low-density lipoprotein red fibers NB nota bene (note well)
LDL-C LDL cholesterol MET metabolic equivalent NCS nerve conduction studies
L-DOPA levodopa Metab metabolism; metabolic NCV nerve conduction velocity
LE lower extremity metHb methemoglobin NDMB nondepolarizing neuromuscular
LES lower esophageal sphincter metHbemia methemoglobinemia blocker
LFT liver function test mets metastases NDMR nondepolarizing muscle relaxant
LGL Lown-Ganong-Levine MF-PCM marasmic form of protein Nd:YAG neodymium:yttrium-aluminum-
syndrome calorie malnutrition garnet
LH luteinizing hormone Mg2+ magnesium NE norepinephrine
LHON Leber hereditary optic MgSO4 magnesium sulfate NEB nebulizer
neuropathy MGUS monoclonal gammopathy of NEC necrotizing enterocolitis
LMA laryngeal mask airway undetermined significance neg negative
LMW low molecular weight MH malignant hyperthermia neuro neurologic
LMWH low molecular weight heparin MI myocardial infarction NF necrotizing fasciitis;
LOC level of consciousness; loss of MILS maternally inherited Leigh neurofibromatosis; neurologic
consciousness syndrome findings
LOS length of stay min minimal; minimum; minute NF-1 neurofibromatosis
LP lumbar puncture MIsch myocardial ischemia NG nasogastric
L-PAM melphalan (Alkeran) MIV mivacurium NGF nerve growth factor
LQTS long QT syndrome mm Hg millimeter(s) of mercury NGT nasogastric tube
LR lactated Ringer’s (solution) MMEFR maximal midexpiratory flow rate NH3 ammonia
LRI lower respiratory tract MMSE Mini–Mental State Examination NHANES National Health and Nutrition
infection mo month Examination Survey
LSB lumber sympathetic block mod moderate NHL non-Hodgkin’s lymphoma
LSD lysergic acid diethylamide MODS multiorgan dysfunction NHLBI National Heart, Lung, and
LTG lamotrigine syndrome Blood Institute
L-to-R left to right MOF multiple organ failure NIBP noninvasive blood pressure
LUQ left upper quadrant MP mucopolysaccharide NICU neonatal intensive care unit
LV left ventricle MPAP mean pulmonary artery NIDDM non–insulin-dependent diabetes
LVAD left ventricular assist device pressure mellitus
LVEDP left ventricular end-diastolic MPS mucopolysaccharidoses NIF negative inspiratory force
pressure MR mitral regurgitation NIH National Institutes of Health
LVEDV left ventricular end-diastolic MRA magnetic resonance NIPHS noninsulinoma pancreatogenous
volume angiography hypoglycemia syndrome
LVEF left ventricular ejection MRI magnetic resonance imaging NIRS near-infrared spectroscopy
fraction MRSA methicillin-resistant NK natural killer (cell)
LVF left ventricular failure Staphylococcus aureus NM neuromuscular
LVH left ventricular hypertrophy MS mental status; mitral NMB neuromuscular blockade
LVOT left ventricular outflow tract stenosis; multiple sclerosis; NMBA neuromuscular blocking agent
xl lytes electrolytes musculoskeletal NMBD neuromuscular blocking drug
Abbreviations
NMDA N-methyl-d-aspartate
PAT paroxysmal atrial tachycardia PONV postoperative nausea and
NMJ neuromuscular junction Paw mean airway pressure vomiting
nml normal PAWP pulmonary artery wedge pos positive
NMO neuromyelitis optica pressure poss possible; possibly
NMS neuroleptic malignant syndrome PBC primary biliary cirrhosis postop postoperative
NO nitric oxide PBF pulmonary blood flow PPAR peroxisome proliferator-
no. number PBG porphobilinogen activated receptor
nondep nondepolarizing PBS peripheral blood smear PPD purified protein derivative
NP nasopharyngeal PCA patient-controlled analgesia (tuberculin)
NP-D Niemann-Pick disease PCC prothrombin complex PPH persistent pulmonary
NPH neutral protamine Hagedorn concentrate hypertension
NPO nil per os (nothing by mouth) PCD primary ciliary dyskinesia PPHN persistent pulmonary
NPPB normal perfusion pressure PCI percutaneous coronary hypertension of newborn
breakthrough (syndrome) intervention PPI proton pump inhibitor
NRI nutritional risk index PCM protein calorie malnutrition Pplat plateau pressure
NRT nictotine replacement therapy PCO polycystic ovary ppm parts per million
NS normal saline (solution) Pco2 partial pressure of carbon PPV positive predictive value;
NSAID nonsteroidal anti-inflammatory dioxide positive pressure ventilation
drug PCP phencyclidine PR per rectum
NT nasotracheal PCR polymerase chain reaction PRA plasma renin activity
NTG nitroglycerin PCW post conceptual week(s) PRBCs packed red blood cells
NTP nucleoside triphosphate PCWP pulmonary capillary wedge preop preoperative
NYHA New York Heart Association pressure prep preparation
PD Parkinson disease; peritoneal prn as needed
O dialysis PRS Pierre Robin sequence
O2 oxygen PDA patent ductus arteriosus PS pulmonary stenosis
OA osteoarthritis PDE II phosphodiesterase III PSA prostate-specific antigen
OAVRT orthodromic atrioventricular (inhibitors) PSC primary sclerosing cholangitis
reciprocating tachycardia PDL pulsed dye laser PSG polysomnography
OB obstetric PDPH post-dural puncture headache PSVT paroxysmal supraventricular
OB/GYN obstetrics/gynecology PD/PK pharmacodynamic/ tachycardia
OC oral contraceptive pharmacokinetic psych psychological
OCD obsessive-compulsive disorder PE physical examination; pt patient
ABBREVIATIONS
OD overdose preeclampsia; pressure PT physical therapy; prothrombin
OFC occipital frontal circumference equalization; pulmonary time
OG orogastric embolism PTCA percutaneous transluminal
OGT orogastric tube PEAC prolonged expiratory apnea with coronary angioplasty
OGTT oral glucose tolerance test cyanosis PTH parathyroid hormone
OHS obesity hypoventilation PEEP positive end-expiratory pressure PTLD post transplant
syndrome PEF peak expiratory flow lymphoproliferative disease
OKT3 Ortho Kung T cell PEG percutaneous endoscopic pts patients
(muromonab-CD3) gastrostomy PTSD posttraumatic stress disorder
OLD obstructive lung disease PEP positive expiratory pressure PTT partial thromboplastin time
OM otitis media periop perioperative PTU propylthiouracil
OMIM Online Mendelian Inheritance PET positron emission tomography PUD peptic ulcer disease
in Man PETCO2 end-tidal partial pressure of pulm pulmonary
ONH optic nerve hypoplasia carbon dioxide PUVA psoralens plus ultraviolet A
OPHTH or PFO patent foramen ovale PVC polyvinyl chloride; premature
ophthal ophthalmologic PFT pulmonary function test ventricular contraction
OR operating room PG prostaglandin PVD peripheral vascular disease
ORIF open reduction internal fixation PGD2 prostaglandin D2 PVO2 partial pressure of oxygen,
ORTHO orthopedic PGE1 alprostadil (prostaglandin E1) venous
OSA obstructive sleep apnea pharm pharmaceutical; pharmacy PVR pulmonary vascular resistance
Osm osmole; osmolality pheo pheochromocytoma PVS primo vascular system
OTC over-the-counter pHTN pulmonary hypertension
physiol physiologic Q
P PID pelvic inflammatory disease Q perfusion
P phosphorus PIH pregnancy-induced q every
P(A-a)o2 alveolar-arterial oxygen hypertension q.a.m. every morning
difference PIP peak inspiratory pressure q.n. every night
PA plasma aldosterone; pulmonary pit pituitary q.p.m. every evening
artery PJP
Pneumocystis jirovecii pneumonia qhs every hour of sleep
PAC premature atrial contraction pKa negative logarithm of the qid four times per day
Paco2 partial pressure of carbon dissociation constant of an Qp:Qs ratio of pulmonary blood to
dioxide, arterial acid systemic blood flow
PACU postanesthesia care unit PKU phenylketonuria QRS Q wave, R wave, S wave
PAF platelet activating factor plt(s) platelet(s) QSART quantitative sudomotor
PAH pulmonary arterial hypertension pM picomolar autonomic reflex testing
PAIR puncture-aspiration-injection- pm evening
respiration PMI posterior myocardial infarction; R
palp palpation of point of maximal intensity R right
Pao2 partial pressure of oxygen in PMS premenstrual syndrome R/O or r/o rule out
arterial blood PNB peripheral nerve block RA rheumatoid arthritis; right
PAOP pulmonary artery occlusion PND paroxysmal nocturnal dyspnea atrial; right atrium
pressure PNS peripheral nervous system RAAS renin-angiotensin-aldosterone
PAP pulmonary artery pressure PO per os system
PAPVD partial anomalous pulmonary Po2 oxygen partial pressure RAD reactive airway disease
venous drainage PO4 phosphate RAE right atrial enlargement xli
Abbreviations
RAH right atrial hypertrophy SEB simplex epidermolysis TBI traumatic brain injury
RAI resting ankle index sec second(s) TBSA total body surface area
RAST radioallergosorbent test SEP sensory evoked potential TBW total body water
RBBB right bundle branch block SERM selective estrogen receptor TCA tricyclic antidepressant
RBC red blood cell modulator TCD transcranial Doppler
RBF renal blood flow SG specific gravity TCS Treacher Collins syndrome
RCM congenital methemoglobinemia SGOT aspartate aminotransferase; TCT thrombin clotting time
of the recessive type serum glutamic-oxaloacetic TEE transesophageal
RCRI Revised Cardiac Risk Index transaminase echocardiography
RCT randomized controlled trial SGPT alanine aminotransferase; TEF transesophageal fistula
RDA recommended daily allowance serum glutamate pyruvate TEG thromboelastography
RDS respiratory distress syndrome transaminase temp temperature
reg regular SIADH syndrome of inappropriate TEN toxic epidermal necrosis
rehab rehabilitation secretion of antidiuretic TENS transcutaneous electrical nerve
REM rapid eye movement hormone stimulation
reprod reproductive SICU surgical ICU tet tetralogy of Fallot
resp respiratory SIDS sudden infant death syndrome TFA trifluoroacetic acid
RFT respiratory function test SIRS systemic inflammatory response TFT thyroid function test
RH releasing hormone syndrome TGA transposition of the great
RHC right heart catheterization SJS Stevens-Johnson syndrome arteries
RHD rheumatic heart disease SJS-TEN Stevens-Johnson syndrome– TGF transforming growth factor
RHF right heart failure toxic epidermal necrolysis THAM tromethamine
RIA radioimmunoassay SL sublingual THC delta-9-tetrahydrocannabinol
RIPA ristocetin-induced platelet SLE systemic lupus erythematosus TIA transient ischemic attack
agglutination SMA superior mesenteric artery TIBC total iron-binding capacity
RLN recurrent laryngeal nerve SND sinus node dysfunction tid three times per day
RNA ribonucleic acid SNP single nucleotide polymorphism TIPS transjugular intrahepatic
ROM range of motion SNS sympathetic nervous system portosystemic shunt
ROP retinopathy of prematurity SOB shortness of breath TIVA total intravenous anesthesia
ROS review of systems SOBOE shortness of breath on exertion TJC The Joint Commission
ROSC return of spontaneous soln solution TKI tyrosine kinase inhibitor
circulation SPECT single-photon emission TLC total lung capacity/compliance
RPGN rapidly progressive computed tomography TM temporomandibular
ABBREVIATIONS
glomerulonephritis SpO2 oxygen saturation as measured TMEP telangiectasia macularis eruptive

RR respiratory rate by pulse oximetry perstans
RRP recurrent respiratory spont spontaneously TMJ temporomandibular joint
papillomatosis SQ subcutaneous; subcutaneously TMO trimethadione
RSV respiratory syncytial virus SSEP somatosensory evoked TMP/SMX trimethoprim/sulfamethoxazole
RT radiation therapy potential TN trigeminal neuralgia
RTA renal tubular acidosis SSP subclavian steal syndrome TNF tumor necrosis factor
RTK receptor tyrosine kinase SSRI selective serotonin reuptake TOF train-of-4; tetralogy of Fallot
R-to-L right-to-left inhibitor TOLAC trial of labor after cesarean
RUQ right upper quadrant SSS sick sinus syndrome TP total protein
RV residual volume; right ST spasmodic torticollis t-PA tissue plasminogen activator
ventricle STD sexually transmitted disease TPN total parenteral nutrition
RVE right ventricular enlargement stim stimulation TPR transient potential receptor
RVH right ventricular hypertrophy STN subthalamic nucleus TR tricuspid regurgitation
RVOT right ventricle outflow tract STSG split-thickness skin graft TRALI transfusion-related acute lung
Rx therapy; treatment; therapeutic STSS streptococcal toxic shock injury
syndrome TRH thyrotropin-releasing hormone
S Stz streptozocin TRPA1 transient receptor potential
S Svedberg unit sup superior ankyrin-1
S/P status post surg surgery; surgical TRPV1 transient receptor potential
SA sinoatrial; beta S/beta A globin SV stroke volume vanilloid-1
gene SVC superior vena cava TRUP transurethral resection of the
SAH subarachnoid hemorrhage SVO2 mixed venous continuous prostate
SAM systolic anterior motion oxygen saturation TSH thyroid-stimulating hormone
SAMe S-adenosyl-l-methionine SVR systemic vascular resistance TT thrombin time
SaO2 oxygen saturation in arterial SVT supraventricular tachycardia TTE transthoracic echocardiography
blood Sx signs and symptoms T-TEPA triethylene-thiophosphoramide
SAP systematic arterial pressure (thiotepa)
SAS sleep apnea syndrome T TTP thrombotic thrombocytopenic
SAT or sat saturation T temperature purpura
SBDP syndromic bile duct paucity T&C type and crossmatch TURBT transurethral resection of
SBE standard base excess; subacute T½ half-life bladder tumor
bacterial endocarditis T3 triiodothyronine TURP transurethral resection of the
SBP systolic blood pressure T4 thyroxine prostate
SCC squamous cell carcinoma TA tricuspid atresia TV tidal volume
SCD sudden cardiac death TACO transfusion-associated Tx transplant; transfusion
SCH succinylcholine circulatory overload TXA2 thromboxane A2
SCID severe combined TAH total abdominal hysterectomy TXA3 thromboxane A3
immunodeficiency TAPVD total anomalous pulmonary TXB2 thromboxane B2
SCLC small cell lung cancer venous drainage TZD thiazolidinedione
SCM sternocleidomastoid TAPVR total anomalous pulmonary
SCS spinal cord stimulation venous return U
SD standard deviation(s) TAVR transcatheter aortic valve UA urinalysis
SDH succinate dehydrogenase replacement UE upper extremity
xlii SDS Shy-Drager syndrome TB tuberculosis UGI upper gastrointestinal
Abbreviations
UK United Kingdom Vd volume of distribution VSD ventricular septal defect

UO urine output VEGF vascular endothelial growth VSS video swallow study
UP urticaria pigmentosa factor VT venous thrombosis; venous
URI or URTI upper respiratory tract vent ventilation thrombus
infection VEP visual evoked potential VTach ventricular tachycardia
urol urology; urologic VEPTR vertical expandable prosthetic VTE venous thromboembolism
US ultrasound titanium rib VVB venovenous bypass
USA United States of America VF or VFIB ventricular fibrillation VVI ventricular inhibited
UT urinary tract VGCC voltage gated calcium channel vWF von Willebrand factor
UTI urinary tract infection VHLD Von Hippel-Lindau disease
UV ultraviolet VIM ventralis intermedius nucleus W
UVGI ultraviolet germicidal irradiation VIPoma vasoactive intestinal peptide- w/ with
secreting tumors w/o without
V vit vitamin WBC white blood cell
V ventilation VKDB vitamin K deficient bleeding WHO World Health Organization
V/Q ventilation-perfusion VLBW very low birth weight wk week(s)
VACTERL vertebral, anal, cardiac, tracheal, VLDL very low density lipoprotein WPW Wolff-Parkinson-White
esophageal, renal, and limb VMA vanillylmandelic acid syndrome
VAE venous air embolism VO2 oxygen consumption per unit wt weight
VAP ventilator-associated pneumonia time
VAS Visual Analogue Scale vol volume XYZ
vasc vascular VP-16 etoposide Xe xenon
VATS video-assisted thoracoscopic VPA valproic acid XR x-ray
surgery VQ ventilation-perfusion XS excessive
VC vital capacity; vocal cord VR venous return y year(s)
VCO2 carbon dioxide consumption per VS vital signs
unit time vs. versus
ABBREVIATIONS
xliii
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Besides the pensions thus bestowed upon resident
mathematicians and astronomers, the governments of Europe have
wisely and usefully employed considerable sums upon expeditions
and travels undertaken by men of science for some appropriate
object. Thus Picard, in 1671, was sent to Uraniburg, the scene of
Tycho’s observations, to determine its latitude and its longitude. He
found that “the City of the Skies” had utterly disappeared from the
earth; and even its foundations were retraced with difficulty. With the
same object, that of accurately connecting the labors of the places
which had been at different periods the metropolis of astronomy,
Chazelles was sent, in 1693, to Alexandria. We have already
mentioned Richer’s astronomical expedition to Cayenne in 1672.
Varin and Deshayes 129 were sent a few years later into the same
regions for similar purposes. Halley’s expedition to St. 481 Helena in
1677, with the view of observing the southern stars, was at his own
expense; but at a later period (in 1698), he was appointed to the
command of a small vessel by King William the Third, in order that
he might make his magnetical observations in all parts of the world.
Lacaille was maintained by the French government four years at the
Cape of Good Hope (1750–4), for the purpose of observing the stars
of the southern hemisphere. The two transits of Venus in 1761 and
1769, occasioned expeditions to be sent to Kamtschatka and
Tobolsk by the Russians; to the Isle of France, and to Coromandel,
by the French; 130 to the isles of St. Helena and Otaheite by the
English; to Lapland and to Drontheim, by the Swedes and Danes. I
shall not here refer to the measures of degrees executed by various
nations, still less the innumerable surveys by land and sea; but I may
just notice the successive English expeditions of Captains Basil Hall,
Sabine, and Foster, for the purpose of determining the length of the
seconds’ pendulum in different latitudes; and the voyages of M. Biot
and others, sent by the French government for the same purpose.
Much has been done in this way, but not more than the progress of
astronomy absolutely required; and only a small portion of that which
the completion of the subject calls for.
129 Bailly, ii. 374.
130 Bailly, iii. 107.
Sect. 6.—Present State of Astronomy.
Astronomy, in its present condition, is not only much the most

advanced of the sciences, but is also in far more favorable
circumstances than any other science for making any future
advance, as soon as this is possible. The general methods and
conditions by which such an advantage is to be obtained for the
various sciences, we shall endeavor hereafter to throw some light
upon; but in the mean time, we may notice here some of the
circumstances in which this peculiar felicity of the present state of
astronomy may be traced.
The science is cultivated by a number of votaries, with an assiduity

and labor, and with an expenditure of private and public resources,
to which no other subject approaches; and the mode of its cultivation
in all public and most private observatories, has this character—that
it forms, at the same time, a constant process of verification of
existing discoveries, and a strict search for any new discoverable
laws. The observations made are immediately referred to the best
tables, and 482 corrected by the best formulæ which are known; and
if the result of such a reduction leaves any thing unaccounted for, the
astronomer is forthwith curious and anxious to trace this deviation
from the expected numbers to its rule and its origin; and till the first,
at least, of these things is performed, he is dissatisfied and unquiet.
The reference of observations to the state of the heavens as known
by previous researches, implies a great amount of calculation. The
exact places of the stars at some standard period are recorded in
Catalogues; their movements, according to the laws hitherto
detected, are arranged in Tables; and if these tables are applied to
predict the numbers which observation on each day ought to give,
they form Ephemerides. Thus the catalogues of fixed stars of
Flamsteed, of Piazzi, of Maskelyne, of the Astronomical Society, are
the basis of all observation. To these are applied the Corrections for
Refraction of Bradley or Bessel, and those for Aberration, for
Nutation, for Precession, of the best modern astronomers. The
observations so corrected enable the observer to satisfy himself of
the delicacy and fidelity of his measures of time and space; his
Clocks and his Arcs. But this being done, different stars so observed
can be compared with each other, and the astronomer can then
endeavor further to correct his fundamental Elements;—his
Catalogue, or his Tables of Corrections. In these Tables, though
previous discovery has ascertained the law, yet the exact quantity,
the constant or coefficient of the formula, can be exactly fixed only
by numerous observations and comparisons. This is a labor which is
still going on, and in which there are differences of opinion on almost
every point; but the amount of these differences is the strongest
evidence of the certainty and exactness of those doctrines in which
all agree. Thus Lindenau makes the coefficient of Nutation rather
less than nine seconds, which other astronomers give as about nine
seconds and three-tenths. The Tables of Refraction are still the
subject of much discussion, and of many attempts at improvement.
And after or amid these discussions, arise questions whether there
be not other corrections of which the law has not yet been assigned.
The most remarkable example of such questions is the controversy
concerning the existence of an Annual Parallax of the fixed stars,
which Brinkley asserted, and which Pond denied. Such a dispute
between two of the best modern observers, only proves that the
quantity in question, if it really exist, is of the same order as the
hitherto unsurmounted errors of instruments and corrections.
[2d Ed.] [The belief in an appreciable parallax of some of the fixed

483 stars appears to gain ground among astronomers. The parallax
of 61 Cygni, as determined by Bessel, is 0″·34; about one-third of a
second, or 1⁄10000 of a degree. That of α Centauri, as determined by
Maclear, is 0″·9, or 1⁄4000 of a degree.]
But besides the fixed stars and their corrections, the astronomer
has the motions of the planets for his field of action. The established
theories have given us tables of these, from which their daily places
are calculated and given in our Ephemerides, as the Berliner
Jahrbuch of Encke, or the Nautical Almanac, published by the
government of this country, the Connaissance des Tems which
appears at Paris, or the Effemeridi di Milano. The comparison of the
observed with the tabular place, gives us the means of correcting the
coefficients of the tables; and thus of obtaining greater exactness in
the constants of the solar system. But these constants depend upon
the mass and form of the bodies of which the system is composed;
and in this province, as well as in sidereal astronomy, different
determinations, obtained by different paths, may be compared; and
doubts may be raised and may be solved. In this way, the
perturbations produced by Jupiter on different planets gave rise to a
doubt whether his attraction be really proportional to his mass, as the
law of universal gravitation asserts. The doubt has been solved by
Nicolai and Encke in Germany, and by Airy in England. The mass of
Jupiter, as shown by the perturbations of Juno, of Vesta, and of
Encke’s Comet, and by the motion of his outermost Satellite, is found
to agree, though different from the mass previously received on the
authority of Laplace. Thus also Burckhardt, Littrow, and Airy, have
corrected the elements of the Solar Tables. In other cases, the
astronomer finds that no change of the coefficients will bring the
Tables and the observations to a coincidence;—that a new term in
the formula is wanting. He obtains, as far as he can, the law of this
unknown term; if possible, he traces it to some known or probable
cause. Thus Mr. Airy, in his examination of the Solar Tables, not only
found that a diminution of the received mass of Mars was necessary,
but perceived discordances which led him to suspect the existence
of a new inequality. Such an inequality was at length found to result
theoretically from the attraction of Venus. Encke, in his examination
of his comet, found a diminution of the periodic time in the
successive revolutions; from which he inferred the existence of a
resisting medium. Uranus still deviates from his tabular place, and
the cause remains yet to be discovered. (But see the Additions to
this volume.) 484
Thus it is impossible that an assertion, false to any amount which

the existing state of observation can easily detect, should have any
abiding prevalence in astronomy. Such errors may long keep their
ground in any science which is contained mainly in didactic works,
and studied in the closet, but not acted upon elsewhere;—which is
reasoned upon much, but brought to the test of experiment rarely or
never. Here, on the contrary, an error, if it arise, makes its way into
the Tables, into the Ephemeris, into the observer’s nightly List, or his
sheet of Reductions; the evidence of sense flies in its face in a
thousand observatories; the discrepancy is traced to its source, and
soon disappears forever.
In this favored branch of knowledge, the most recondite and

delicate discoveries can no more suffer doubt or contradiction, than
the most palpable facts of sense which the face of nature offers to
our notice. The last great discovery in astronomy—the motion of the
stars arising from Aberration—is as obvious to the vast population of
astronomical observers in all parts of the world, as the motion of the
stars about the pole is to the casual night wanderer. And this
immunity from the danger of any large error in the received
doctrines, is a firm platform on which the astronomer can stand and
exert himself to reach perpetually further and further into the region
of the unknown.
The same scrupulous care and diligence in recording all that has
hitherto been ascertained, has been extended to those departments
of astronomy in which we have as yet no general principles which
serve to bind together our acquired treasures. These records may be
considered as constituting a Descriptive Astronomy; such are, for
instance, Catalogues of Stars, and Maps of the Heavens, Maps of
the Moon, representations of the appearance of the Sun and Planets
as seen through powerful telescopes, pictures of Nebulæ, of
Comets, and the like. Thus, besides the Catalogue of Fundamental
Stars which may be considered as standard points of reference for
all observations of the Sun, Moon, and Planets, there exist many
large catalogues of smaller stars. Flamsteed’s Historia Celestis,
which much surpassed any previous catalogue, contained above
3000 stars. But in 1801, the French Histoire Céleste appeared,
comprising observations of 50,000 stars. Catalogues or charts of
other special portions of the sky have been published more recently;
and in 1825, the Berlin Academy proposed to the astronomers of
Europe to carry on this work by portioning out the heavens among
them.
[2d Ed.] [Before Flamsteed, the best Catalogue of the Stars was
485 Tycho Brahe’s, containing the places of about 1000 stars,
determined very roughly with the naked eye. On the occasion of a
project of finding the longitude, which was offered to Charles II., in
1674, Flamsteed represented that the method was quite useless, in
consequence, among other things, of the inaccuracy of Tycho’s
places of the stars. Flamsteed’s letters being shown King Charles,
he was startled at the assertion of the fixed stars’ places being false
in the Catalogue, and said, with some vehemence, “He must have
them anew observed, examined, and corrected for the use of his
seamen.” This was the immediate occasion of building Greenwich
Observatory, and placing Flamsteed there as an observer.
Flamsteed’s Historia Celestis contained above 3000 stars, observed
with telescopic sights. It has recently been republished with
important improvements by Mr. Baily. See Baily’s Flamsteed, p. 38.
The French Histoire Céleste was published in 1801 by Lalande,

containing 50,000 stars, simply as observed by himself and other
French astronomers. The reduction of the observations contained in
this Catalogue to the mean places at the beginning of the year 1800
may be effected by means of Tables published by Schumacher for
that purpose in 1825.
In 1807, Piazzi’s Catalogue of 6748 stars, founded on Maskelyne’s

Catalogue of 1700, was published; afterwards extended to 7646
stars in 1814. This is considered as the greatest work undertaken by
any modern astronomer; the observations being well made, reduced,
and compared with those of former astronomers. Piazzi’s Catalogue
is the standard and accurate Catalogue, as the Histoire Céleste is
the standard approximate Catalogue for small stars. But the new
planets were discovered mostly by a comparison of the heavens with
Bode’s (Berlin) Catalogue.
I may mention other Catalogues of Stars which have recently been
published. Pond’s Catalogue contains 1112 Northern stars;
Johnson’s, 606; Wrottesley’s, 1318 (in Right Ascension only); Airy’s
First Cambridge Catalogue, 726; his Greenwich Catalogue, 1439.
Pearson’s has 520 zodiacal stars; Groombridge’s, 4243 circumpolar
stars as far as 50 degrees of North Polar distance; Santini’s, a zone
18 degrees North of the equator. Besides these, Mr. Taylor has
published, by order of the Madras government, a Catalogue of
11,000 stars observed by him at Madras; and Rumker, who observed
in the Observatory established by Sir Thomas Brisbane at Paramatta
(in Australia), has commenced a Catalogue which is to contain
12,000. Mr. Baily 486 published two Standard Catalogues; that of the
Royal Astronomical Society, containing 2881 stars; and that of the
British Association, containing 8377 stars. I omit other Catalogues,
as those of Argelander, &c., and Catalogues of Southern Stars.
Of the Berlin Maps, fourteen hours in Right Ascension have been

published; and their value may be judged of by this circumstance,
that it was in a great measure by comparing the heavens with these
Maps that the new planet Astræa was discovered. The Zone
observations made at Königsberg, by the late illustrious astronomer
Bessel, deserve to be mentioned, as embracing a vast number of
stars.
The common mode of designating the Stars is founded upon the

ancient constellations as given by Ptolemy; to which Bayer, of
Augsburg, in his Uranometria, added the artifice of designating the
brightest stars in each constellation by the Greek letters, α, β, γ, &c.,
applied in order of brightness, and when these were exhausted, the
Latin letters. Flamsteed used numbers. As the number of observed
stars increased, various methods were employed for designating
them; and the confusion which has been thus introduced, both with
regard to the boundaries of the constellations and the nomenclature
of the stars in each, has been much complained of lately. Some
attempts have been made to remedy this variety and disorder. Mr.
Argelander has recently recorded stars, according to their
magnitudes as seen by the naked eye, in a Neue Uranometrie.
Among representations of the Moon I may mention Hevelius’s

Selenographia, a work of former times, and Beer and Madler’s Map
of the Moon, recently published.]
I have already said something of the observations of the two

Herschels on Double Stars, which have led to a knowledge of the
law of the revolution of such systems. But besides these, the same
illustrious astronomers have accumulated enormous treasures of
observations of Nebulæ; the materials, it may be, hereafter, of some
vast new generalization with respect to the history of the system of
the universe.
[2d Ed.] [A few measures of Double Stars are to be found in

previous astronomical records. But the epoch of the creation of this
part of the science of astronomy must be placed at the beginning of
the present century, when Sir William Herschel (in 1802) published in
the Phil. Trans. a Catalogue of 500 new Nebulæ of various classes,
and in the Phil. Trans. 1803, a paper “On the changes in the relative
situation of the Double Stars in 25 years.” In succeeding papers he
pursued the subject. In one in 1814 he noticed the breaking up of the
487 Milky Way in different places, apparently from some principle of
Attraction; and in this, and in one in 1817, he published those
remarkable views on the distribution of the stars in our own cluster
as forming a large stratum, and on the connection of stars and
nebulæ (the stars appearing sometimes to be accompanied by
nebulæ, sometimes to have absorbed a part of the nebula, and
sometimes to have been formed from nebulæ), which have been
accepted and propounded by others as the Nebular Theory. Sir
William Herschel’s last paper was a Catalogue of 145 new Double
Stars communicated to the Astronomical Society in 1822. In 1827 M.
Struve, of Dorpat (in Russia), published his Catalogus Novus,
containing the places of 3112 double stars. While this was going on,
Sir John Herschel and Sir James South published (in the Phil. Trans.
1824) accurate measures of 380 Double and Triple Stars, to which
Sir J. South afterwards added 458. Mr. Dunlop published measures
of 253 Southern Double Stars. Other Observations have been
published by Capt. Smyth, Mr. Dawes, &c. The great work of Struve,
Mensuræ Micrometricæ, &c., contains 3134 such objects, including
most of Sir W. Herschel’s Double Stars. Sir J. Herschel in 1826, 7,
and 8 presented to the Astronomical Society about 1000 measures
of Double Stars; and in 1830, good measures of 1236, made with his
20-feet reflector. His paper in vol. v. of the Ast. Soc. Mem., besides
measures of 364 such stars, exhibits all the most striking results, as
to the motion of Double Stars, which have yet been obtained. In
1835 he carried his 20-feet reflector to the Cape of Good Hope for
the purpose of completing the survey of Double Stars and Nebulæ in
the southern hemisphere with the same instruments which had
explored the northern skies. He returned from the Cape in 1838, and
is now (1846) about to give the world the results of his labors.
Besides the stars just mentioned, his work will contain from 1500 to
2000 additional double stars; making a gross number of above 8000;
in which of course are included a number of objects of no great
scientific interest, but in which also are contained the materials of the
most important discoveries which remain to be made by
astronomers. The publication of Sir John Herschel’s great work upon
Double Stars and Nebulæ is looked for with eager interest by
astronomers.
Of the observations of Nebulæ we may say what has just been

said of the observations of Double Stars;—that they probably contain
the materials of important future discoveries. It is impossible not to
regard these phenomena with reference to the Nebular Hypothesis,
which has been propounded by Laplace, and much more strongly
488 insisted upon by other persons;—namely, the hypothesis that
systems of revolving planets, of which the Solar System is an
example, arise from the gradual contraction and separation of vast
masses of nebulous matter. Yet it does not appear that any changes
have been observed in nebulæ which tend to confirm this
hypothesis; and the most powerful telescope in the world, recently
erected by the Earl of Rosse, has given results which militate against
the hypothesis; inasmuch as it has shown that what appeared a
diffused nebulous mass is, by a greater power of vision, resolved, in
all cases yet examined, into separate stars.
When astronomical phenomena are viewed with reference to the

Nebular Hypothesis, they do not belong so properly to Astronomy, in
the view here taken of it, as to Cosmogony. If such speculations
should acquire any scientific value, we shall have to arrange them
among those which I have called Palætiological Sciences; namely,
those Sciences which contemplate the universe, the earth, and its
inhabitants, with reference to their historical changes and the causes
of those changes.]
ADDITIONS TO THE THIRD EDITION.
INTRODUCTION.
T HERE is a difficulty in writing for popular readers a History of the

Inductive Sciences, arising from this;—that the sympathy of such
readers goes most readily and naturally along the course which
leads to false science and to failure. Men, in the outset of their
attempts at knowledge, are prone to rush from a few hasty
observations of facts to some wide and comprehensive principles;
and then, to frame a system on these principles. This is the opposite
of the method by which the Sciences have really and historically
been conducted; namely, the method of a gradual and cautious
ascent from observation to principles of limited generality, and from
them to others more general. This latter, the true Scientific Method,
is Induction, and has led to the Inductive Sciences. The other, the
spontaneous and delusive course, has been termed by Francis
Bacon, who first clearly pointed out the distinction, and warned men
of the error, Anticipation. The hopelessness of this course is the
great lesson of his philosophy; but by this course proceeded all the
earlier attempts of the Greek philosophers to obtain a knowledge of
the Universe.
Laborious observation, narrow and modest inference, caution,

slow and gradual advance, limited knowledge, are all unwelcome
efforts and restraints to the mind of man, when his speculative spirit
is once roused: yet these are the necessary conditions of all
advance in the Inductive Sciences. Hence, as I have said, it is
difficult to win the sympathy of popular readers to the true history of
these sciences. The career of bold systems and fanciful pretences of
knowledge is more entertaining and striking. Not only so, but the
bold guesses and fanciful reasonings of men unchecked by doubt or
fear of failure are often presented as the dictates of Common Sense;
—as the plain, unsophisticated, unforced reason of man, acting
according to no artificial rules, but following its own natural course.
Such Common Sense, while it 490 complacently plumes itself on its
clear-sightedness in rejecting arbitrary systems of others, is no less
arbitrary in its own arguments, and often no less fanciful in its
inventions, than those whom it condemns.
We cannot take a better representative of the Common Sense of

the ancient Greeks than Socrates: and we find that his Common
Sense, judging with such admirable sagacity and acuteness
respecting moral and practical matters, offered, when he applied it to
physical questions, examples of the unconscious assumptions and
fanciful reasonings which, as we have said, Common Sense on such
subjects commonly involves.
Socrates, Xenophon tells us (Memorabilia, iv. 7), recommended

his friends not to study astronomy, so as to pursue it into scientific
details. This was practical advice: but he proceeded further to speak
of the palpable mistakes made by those who had carried such
studies farthest. Anaxagoras, for instance, he said, held that the Sun
was a Fire:—he did not consider that men can look at a fire, but they
cannot look at the Sun; they become dark by the Sun shining upon
them, but not so by the fire. He did not consider that no plants can
grow well except they have sunshine, but if they are exposed to the
fire they are spoiled. Again, when he said that the Sun was a stone
red-hot, he did not consider that a stone heated by the fire is not
luminous, and soon cools, but the Sun is always luminous and
always hot.
We may easily conceive how a disciple of Anaxagoras would reply
to these arguments. He would say, for example, as we should
probably say at present, that if there were a mass of matter so large
and so hot as Anaxagoras supposed the Sun to be, its light might be
as great and its heat as permanent as the heat and light of the Sun
are, as yet, known to be. In this case the arguments of Socrates are
at any rate no better than the doctrine of Anaxagoras.
BOOK I.
THE GREEK SCHOOL PHILOSOPHY.

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CIED cardiac implantable electronic CTX cyclophosphamide (Cytoxan) Dx diagnosis; diagnostic

COX cyclooxygenase dec decleration(s) ELISA enzyme-linked immunosorbent

F GI gastrointestinal HRCT high-resolution computed

glomerulonephritis SpO2 oxygen saturation as measured TMEP telangiectasia macularis eruptive

UK United Kingdom Vd volume of distribution VSD ventricular septal defect

130 Bailly, iii. 107.

Sect. 6.—Present State of Astronomy.

Astronomy, in its present condition, is not only much the most

The science is cultivated by a number of votaries, with an assiduity

[2d Ed.] [The belief in an appreciable parallax of some of the fixed

Thus it is impossible that an assertion, false to any amount which

In this favored branch of knowledge, the most recondite and

The French Histoire Céleste was published in 1801 by Lalande,

In 1807, Piazzi’s Catalogue of 6748 stars, founded on Maskelyne’s

Of the Berlin Maps, fourteen hours in Right Ascension have been

The common mode of designating the Stars is founded upon the

Among representations of the Moon I may mention Hevelius’s

I have already said something of the observations of the two

[2d Ed.] [A few measures of Double Stars are to be found in

Of the observations of Nebulæ we may say what has just been

When astronomical phenomena are viewed with reference to the

T HERE is a difficulty in writing for popular readers a History of the

Laborious observation, narrow and modest inference, caution,

We cannot take a better representative of the Common Sense of

CIED cardiac implantable electronic CTX cyclophosphamide (Cytoxan) Dx diagnosis; diagnostic

COX cyclooxygenase dec decleration(s) ELISA enzyme-linked immunosorbent

F GI gastrointestinal HRCT high-resolution computed

glomerulonephritis SpO2 oxygen saturation as measured TMEP telangiectasia macularis eruptive

UK United Kingdom Vd volume of distribution VSD ventricular septal defect