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Anesthesiology CME Program  |   August 2005
Instructions for Obtaining Journal CME Credit
Article Information
Anesthesiology CME Program
Anesthesiology CME Program   |   August 2005
Instructions for Obtaining Journal CME Credit
Anesthesiology 8 2005, Vol.103, 449-450. doi:
Anesthesiology 8 2005, Vol.103, 449-450. doi:
Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
  1. Read the article by Michard entitled “Changes in arterial pressure during mechanical ventilation” on page 419 of this issue.

  2. Review the questions and other required information for CME program completion (published in both the print and online journal).

  3. When ready, go to the CME Web site: . Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.

The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA’s Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.
Purpose:  The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience:  Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives:  After reading this article, participants should have a better understanding of what changes in invasively measured arterial blood pressure produced by mechanical ventilation can tell us about hemodynamic function and status.
Disclosure Information:
Authors  – Frédéric Michard, M.D., Ph.D. Grants or research support:  None Consultantships or honoraria:  None The article authored by Dr. Michard was supported solely from institutional and/or departmental sources.
Question Writer  –Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Article Questions
Based on the article by Michard entitled “Changes in arterial pressure during mechanical ventilation”in the August issue of Anesthesiology, choose the one correct answer for each question:
After the onset of mechanical ventilation and a positive pressure breath, blood flow is most likely  to decrease first in the
Pulmonary arteries
Aorta
Inferior vena cava
Pulmonary veins
Which of the following mechanisms is most likely  to contribute to the respiratory variation in left ventricular stroke volume associated with the onset of mechanical ventilation and a positive pressure breath in patients with normal cardiovascular function?
Increased left ventricular afterload
Decreased left ventricular afterload
Decreased right ventricular afterload
Decreased right ventricular preload
The “▵up” component of systolic pressure variation in association with the onset of mechanical ventilation and a positive pressure breath is best  described as the difference between the maximum systolic blood pressure during the positive pressure breath and the
Diastolic blood pressure before the onset of the positive pressure breath
Systolic blood pressure before the onset of the positive pressure breath
Lowest systolic blood pressure during the positive pressure breath
Lowest diastolic blood pressure during the positive pressure breath
The “▵down” component of systolic pressure variation in association with the onset of mechanical ventilation and a positive pressure breath is best  described as the difference between the minimum systolic blood pressure during the positive pressure breath and the
Diastolic blood pressure before the onset of the positive pressure breath
Systolic blood pressure before the onset of the positive pressure breath
Lowest systolic blood pressure during the positive pressure breath
Lowest diastolic blood pressure during the positive pressure breath
In patients without significant cardiovascular disease, which statement concerning the systolic pressure variation (SPV) is most likely  true?
An SPV of more than 10 mmHg indicates hypervolemia.
An SPV of more than 10 mmHg indicates hypovolemia.
SPV has a positive correlation with pulmonary artery occlusion pressure.
SPV has a positive correlation with left ventricular end-diastolic volume.
In patients with congestive heart failure, which statement concerning systolic pressure variation associated with the onset of mechanical ventilation and a positive pressure breath is most likely  true?
The ▵down becomes more significant because the left ventricle is now much more afterload sensitive.
The ▵down becomes more significant because the left ventricle is now much more preload sensitive.
The ▵up becomes more significant because the left ventricle is now much more afterload sensitive.
The ▵up becomes more significant because the left ventricle is now much more preload sensitive.