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The brachial or carotid arteries are accessible; the use of EMLA creammay facilitate arterial line placement. Given the propensity for gas trap-ping in MAS, there is some concern that usingSIPPV may lead to high levels of inadvertent pos-itive end-expiratory pressure (PEEP) with resul-tant hyperin?ation
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It has been estimated that symptoms of PD occurwhen more than 50% of nigra neurons have been lost, butrecent data challenge this notion (Ince et al., 2008).
Current guideline is to givewarfarin to a target INR of 2–3 in AF patientswith high risk for stroke (elderly, heart failure,etc.), and to reserve aspirin for low risk patientsor for those unable to take warfarin.
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