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A 62-Year-Old Man Undergoes a Partial Pancreatectomy for Exocrine Pancreatic

question 384

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A 62-year-old man undergoes a partial pancreatectomy for exocrine pancreatic cancer. The surgery is complicated by excessive peripancreatic bleeding requiring careful surgical hemostasis. The patient receives packed red blood cell transfusion during the surgery as well as intravenous normal saline. He is transferred to the surgical intensive care unit for close monitoring and is successfully extubated. Twelve hours later, the nurse reports decreased oxygen saturation. The patient has received multiple doses of morphine for pain control since the surgery. Temperature is 37.5 C (99.5 F) , blood pressure is 80/40 mm Hg, pulse is 112/min, and respirations are 28/min. The patient's pulse oximetry shows 87% on 4 L nasal cannula oxygen. Examination reveals bilateral basal crackles. The abdomen is mildly distended and tender, and bowel sounds are decreased. There is no rebound tenderness or rigidity. Pulmonary artery catheter readings show a cardiac index of 2 L/min/m² (normal, 2.8-4.2) and a pulmonary capillary wedge pressure of 20 mm Hg (normal, 6-15) . Which of the following is the most likely etiology of this patient's current condition?

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Empirical Discipline

A field of study that relies on observation, experimentation, and evidence-based methods to acquire knowledge.

Groupthink

A psychological phenomenon where the desire for harmony and conformity in a group leads to an irrational or dysfunctional decision-making outcome.

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Employees or members of the National Aeronautics and Space Administration, which is the United States government agency responsible for the nation's civilian space program and for aeronautics and aerospace research.

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