Definition: In this task, you are given a question and answer options for that question. Using this information, you have to classify each text into different topics: medicine, nursery, psychology, chemistry, pharmacology, biology.
Input: Question: A 40-year-old patient, classified as ASA I according to the scale of the American Society of Anesthesiologists, is undergoing laparoscopic cholecystectomy for cholelithiasis. The intervention takes place initially without complications, but fifty minutes into the procedure there is a significant increase in the levels of teleespiratory carbon dioxide (CO2), without altering the oxygen saturation by pulse oximetry or raising the ventilation pressures . What would be your diagnosis of presumption and your attitude to this finding?
Options: <0> With these findings we must suspect the existence of subcutaneous emphysema, so we must explore the patient and request that the insufflation pressure of the pneumoperitoneum be reduced or even interrupted. <1> The most likely diagnosis is a pneumothorax secondary to carbon dioxide or capnothorax, so an urgent chest radiograph must be ordered and the insertion of a thoracic drain must be prepared. <2> The elevation of carbon dioxide levels is normal in the context of a laparoscopic intervention. The only attitude to take is to increase the minute volume in the anesthetic machine. <3> The placement of the orotracheal tube should be checked for the possibility that it has progressed and that we are facing an endobronchial intubation, which is relatively frequent in this surgery due to the elevation of the diaphragm secondary to the pneumoperitoneum. <4> Elevation of the teleespiratory carbon dioxide, without affecting ventilation pressures, is typical of massive pulmonary embolism. The intervention must be interrupted, ventilated with pure oxygen and prepare vasoactive drugs for the possible hemodynamic instability.
Output:
medicine