[Keith Allman] Oxford Handbook Of Anaesthesia
.pdf
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 *@2;+,#(6.'-;6,6
*+;#'=4+' |
%52,..,-?(.8'(5@2;+46(146#2'(2;-?,.4=,-"22@(=;/-(.;(.8'(14#;6" |
J,1' |
T_(1,- |
*",- |
m |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e,-,1"2 |
*+"#.,#"2(.'#8-,S4' c[(m(K**VG(zf%K
*+';5'+".,&'
K-#,='-#'(;A(O(,-(TW_(>,+.86G(1"@(>'(#;11;-'+(,-(A,+6.(>;+-(1"2'6C(Z_s("+'(1"2'G(O_s("+'(5+'1".4+'C
DA.'-(5+'6'-.(/,.8(>,;#8'1,#"2(">-;+1"2,.,'6G(-;.">2@(8@5;#82;+"'1,#("2$"2;6,6C(J8'(;5'+".,;-(,6(-'&'+(4+?'-.("-=(A422(+'646#,.".,;- 68;42=(;##4+C
02'#.+;2@.'6G(5"+.,#42"+2@(#82;+,='("-=(>,#"+>;-".'G("-=(5d(68;42=(>'(/,.8,-(-;+1"2(2,1,.6C(N82;+,='(,6(.8'(1;6 .(,15;+."-.(,;-(A;+ "66'661'-.("-=(146 .(>'(?+'".'+(.8"-(p_(11;2h2,.+'C
*'+,;5'+".,&'
:;(#;152'.'("?+''1'-.G(>4.(.8'+'(,6("(+,6$(;A(5421;-"+@("65,+".,;-(A+;1(?"6.+,#(;4.A2;/(;>6.+4#.,;-C
[(-"6;?"6.+,#(.4>'(,6(#;15426;+@("-=(/,22(>'(,-(6,.4C([65,+".'("-=(=;(-;.(+'1;&'C(K.(=;'6(-;.(+'=4#'(.8'('AA'#.(;A(#+,#;,=(5+'664+'("-= 1"@("#.("6("-('6#"5'(&"2&'(,A(1"6$(&'-.,2".,;-(,-#+'"6'6(,-.+"?"6.+,#(5+'664+'C
KV(,6(464"22@(,-(52"#'C(K-=4#.,;-(1"@(>'(+"5,=(6'S4'-#'(;+(-;-I='5;2"+,B,-?(+'2"E"-.(A;+(/8,#8(6;1'("-"'6.8'.,6.6(46'(#+,#;,= 5+'664+'C(N;-6,='+(+"5,=(6'S4'-#'(,A(.8'+'(,6('E#'66,&'(-"6;?"6.+,#(2;66(MqQ12h$?h8RC
H'-."-@2(MO(x?h$?R(m(5"+"#'."1;2(6455;6,.;+@(MQ_PT_(1?h$?R(m(2;#"2(,-A,2.+".,;-(45(.;(O(12h$?(;A(_CQWs(>45,&"#",-'C
0E.4>".'("/"$'(,-(.8'(2'A.(2".'+"2(5;6,.,;-C
*;6.;5'+".,&'
f'1;&'(.8'(-"6;?"6.+,#(.4>'(".(.8'('-=(;A(.8'(5+;#'=4+'C c,&'(5"+"#'."1;2(*Dh*fC
H''=(/,.8,-(X(8(>4.(1",-.",-(A24,=6(4-.,2(A''=,-?(,6('6.">2,68'=C
F6'("-("5-;'"("2"+1(;&'+-,?8.C
%5'#,"2(#;-6,='+".,;-6
f'646#,.".,;-L(_CUWs(6"2,-'(m(Q_(11;2h2,.+'(^N2C(f'52"#'(-"6;?"6.+,#(2;66(/,.8(-;+1"2(6"2,-'(m(Q_(11;2h2,.+'(^N2C(F6'(#;22;,=(,A 8@5;&;2"'1,"(,6(5+'6'-.C(e,2=(#"6'6(1"@(+'65;-=(.;(Ws(='E.+;6'(/,.8(_CUWs(6"2,-'(M>,#"+>;-".'(uTQ(11;2h2,.+'RG(1;+'(6'&'+'(#"6'6 /,22(+'S4,+'(-;+1"2(6"2,-'C
e"@(>'(5'+A;+1'=(2"5"+;6#;5,#"22@C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 K-.46646#'5.,;-
*+;#'=4+' |
f'=4#.,;-(;A(,-&"?,-".'=(M464"22@(,2';#;2,#R(>;/'2 |
J,1' |
OPQ(8 |
*",- |
mmm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e;='+".'G(1"@(>'(2"+?' |
*+"#.,#"2(.'#8-,S4' f%K(m(K**V
*+';5'+".,&'
K-.46646#'5.,;-(,6(.8'(#;11;-'6 .(#"46'(;A(;>6.+4#.,;-(,-(,-A"-.6(;&'+(Q(1;-.86(;A("?'](,-#,='-#'(Q(,-(O___(>,+.86C
K-&"?,-".,;-(;A(.8'(>;/'2(,-.;("-("=\"#'-.(2;/'+(6'?1'-.G(464"22@(".(.8'(.'+1,-"2(,2'41(;+(,2';#;2,#(&"2&'C(f"+'2@(#"46'=(>@(5;2@5(;+ e'#$'296(=,&'+.,#4241(MWs(;A(#"6'6RC
*+'6'-.(/,.8(5"+;E@61"2(5",-G(>2;;=("-=(14#46(,-(6.;;2(M+'=#4++'-.(\'22@(6.;;2RG("-=(6"46"?'I68"5'=(1"66(,-(+,?8.(">=;1'-C Y_s(;A(#"6'6("+'(+'=4#'=(>@(",+(;+(>"+,41('-'1"C
J8'(#8,2=(1"@(>'(5+;A;4-=2@(68;#$'=C(F+?'-.(A24,=(+'646#,.".,;-(/,.8(?"6.+,#(='#;15+'66,;-("-=('2'#.+;2@.'(#;++'#.,;-(/,22(>'(-''='=C N;22;,=("-=(>2;;=(1"@(>'(+'S4,+'=C(<'2"@(1"@(+'642.(,-(5'+A;+".'=(;+(-'#+;.,#(>;/'2C(H24,=(2;66(1"@(>'(?+'".'+(.8"-('E5'#.'=C
*'+,;5'+".,&'
f"5,=(6'S4'-#'(,-=4#.,;-C(f'.",-(.8'(-"6;?"6 .+,#(.4>'(,-(6,.4C
H'-."-@2(QPW(x?h$?(m(&;2".,2'("?'-.C(N;-6,='+("-('5,=4+"2(,A(6.">2'C
J/;(6'#4+'(#"--42"6(;A("='S4".'(6,B'C([(#'-.+"2(2,-'(,6(;A.'-(46'A42(,-(6'&'+'(#"6'6C f;4.,-'(1;-,.;+,-?G(.'15'+".4+'(1'"64+'1'-.(5+;>'G("-=(4+,-"+@(#".8'.'+C
*+;2;-?'=(,-.46646#'5.,;-(/,.8(,6#8"'1,#(?4.(+'S4,+,-?(+'6'#.,;-(;A.'-(2'"=6(.;(1'.">;2,#("#,=;6,6("-=(6'5.,#(68;#$C([=1,66,;-(.;(" 5"'=,".+,#(KNF(/,22(>'(+'S4,+'=C
*;6.;5'+".,&'
a;#"2(/;4-=(,-A,2.+".,;-(m(1;+58,-'(:N[C %5'#,"2(#;-6,='+".,;-6
:;(#;-#'-646("6(.;(/8'.8'+(.8'(#8,2=(68;42=(+'#',&'(64+?'+@(".(.8'(>"6'(8;65,."2(;+(>'(.+"-6A'++'=(.;("(+'?,;-"2(#'-.+'C(KA(.+"-6A'++'=G(.8,6 68;42=(-;.(='2"@(+'646#,.".,;-(;+(>2;;=(#+;66I1".#8G(/8,#8(#"-(>'(6'-.(/,.8(.8'(5".,'-.C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 d'+-,;.;1@
*+;#'=4+' |
0E#,6,;-(;A(5".'-.(5+;#'6646(&"?,-"2,6 |
J,1' |
Q_(1,- |
*",- |
mm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e,-,1"2 |
|
%V(m(ae[G(#"4="2(;+(+'?,;-"2(>2;#$ |
*+"#.,#"2(.'#8-,S4' K**VG(#"4="2(;+(2;#"2(,-A,2.+".,;-
%5,-"2(;+(#"4="2(>2;#$
*+';5'+".,&'
D.8'+/,6'(A,.([%[(O(#8,2=+'-C
Q_s(;A(5+'.'+1(>">,'6(5+'6'-.(A;+(64+?'+@(".("55+;E,1".'2@(U_(/''$6(5;6.#;-#'5.4"2("?'(;+(/8'-(+'"=@(.;(2'"&'(.8'(65'#,"2(#"+'(>">@ 4-,.C
D>.",-(#;-6'-.(A;+(6455;6,.;+@("-=(>2;#$C(<,6#466(+,6$6("-=(#;152,#".,;-6C
*'+,;5'+".,&'
KA(qW($?(,-8"2".,;-"2(;+(KV(,-=4#.,;-(/,.8(2"+@-?'"2(1"6$G(.8'-(#"4="2(;+(,2,;,-?4,-"2(>2;#$("-=(,-.+"I;5'+".,&'(;5,;,=6(,A(-'#'66"+@C
KA(uW($?G(,-.4>".'(/,.8(#;-.+;22'=(&'-.,2".,;-C(K-(-';-".'6G("&;,=(,2,;,-?4,-"2(>2;#$("6(.8'(65+'"=(;A(2;#"2("-"'6.8'.,#(1"@(;>6#4+'(.8'
64+?,#"2(A,'2=C(F6'(',.8'+(#"4="2(;+(5;6.;5'+".,&'(,-A,2.+".,;-C
<,#2;A'-"#(MO(1?h$?R(6455;6,.;+@(MqO(@+R(;+(5"+"#'."1;2(MQ_PT_(1?h$?R(6455;6,.;+@(,A(4-='+(O(@'"+C
*;6.;5'+".,&'
<"@(#"6'L(*f:(5"+"#'."1;2("-=(=,#2;A'-"#C :';-".'L(*f:(5"+"#'."1;2C([=1,.(;&'+-,?8.C
%5'#,"2(#;-6,='+".,;-6
J8'(1"\;+,.@(;A(8'+-,;.;1@(+'5",+6("+'(,-(8'"2.8@(#8,2=+'-("-=(64,.">2'("6(="@(#"6'6C
J8'+'(,6(-;(#;-6'-646("6(.;(.8'(1;6.("55+;5+,".'(+'?,;-"2(>2;#$C(N"4="2(>2;#$"='(,6(,-=,#".'=(A;+(>,2".'+"2(8'+-,;.;1@(+'5",+("-= #8,2=+'-(45(.;(Q_($?C(K2,;,-?4,-"2(>2;#$(,6('AA'#.,&'(,-(#8,2=+'-(;&'+(W($?C
J8'('EI5+'1".4+'(>">@(1"@(>'(61"22(A;+(=".'6("-=(;E@?'-I='5'-='-.(/,.8(#8+;-,#(24-?(=,6'"6'C(*;6.;5'+".,&'("5-;'"("-= >+"=@#"+=,"("+'(=;#41'-.'=(+,6$6("66;#,".'=(/,.8(?'-'+"2("-"'6.8'6,"(A;+(.8,6(?+;45C(d@5;#"+>,"("-=(8@5;.8'+1,"(68;42=(>'("&;,='= "-=("-(;E@?'-(6".4+".,;-(>'./''-(p_s("-=(pWs(,6("##'5.">2'C(N"AA',-'(MO_(1?h$?(KVR(?,&'-(".(,-=4#.,;-(+'=4#'6(.8'(+,6$(;A("5-;'"(>@ Y_sC
*CZ_T
J;("&;,=(?'-'+"2("-"'6.8'6,"("(65,-"2(.'#8-,S4'(1"@(>'(46'=(M_CO(12h$?(;A(_CWs(k8'"&@l(>45,&"#",-'(m(_C_X(12(A;+(-''=2'(='"=(65"#'RC J8,6(1"@(>'(.'#8-,#"22@(=,AA,#42.("-=(#;152,#".'=(>@("(>2;;=@(;+(=+@(."5C(K.(,6(.;;(68;+.("#.,-?(A;+(>,2".'+"2(+'5",+C([(6,-?2'I68;.(#"4="2(,6 "-("2.'+-".,&'(1'.8;=C(%4552'1'-."+@(6'=".,;-(+'642.6(,-(.8'(6"1'(+,6$(;A(5;6.;5'+".,&'("5-;'"("6(/,.8(?'-'+"2("-"'6.8'6,"C J'+1(>">,'6(,-(.8'(A,+6.(X(/''$6(;A(2,A'("-=('EI5+'1".4+'(,-A"-.6(45(.;(X_(/''$69(5;6 .I#;-#'5.4"2("?'(68;42=(>'("=1,..'=(;&'+-,?8.(A;+ ;E@?'-(6".4+".,;-("-=("5-;'"("2"+1(1;-,.;+,-?C
[(6.+"-?42".'=(8'+-,"(.8".(=;'6(-;.(+'=4#'(,6("-('1'+?'-#@("-=(+'S4,+'6(A24,=(+'646#,.".,;-("-=("(-"6;?"6.+,#(.4>'C(*+'#"4.,;-6 68;42=(>'(."$'-("?",-6.(+'?4+?,.".,;-("-=("65,+".,;-C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 N,+#41#,6,;-
*+;#'=4+' |
f'1;&"2(;A(5+'54#'(;+(A;+'6$,- |
J,1' |
Q_(1,- |
*",- |
mm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e,-,1"2 |
*+"#.,#"2(.'#8-,S4' %VG(ae[G(#"4="2h5'-,2'(>2;#$h+,-?(>2;#$
*+';5'+".,&'
N;11;-(="@(#"6'(5+;#'=4+'G(>4.(1;&'(.;/"+=6(1;+'(#;-6'+&".,&'(1"-"?'1'-.(,-#24=,-?(6,152'(6.+'.#8(;+(5+'54.,;52"6.@C D>.",-(#;-6'-.(A;+(6455;6,.;+@("-=(+'?,;-"2(>2;#$C(<,6#466(#;152,#".,;-6("-=(+,6$6C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-C(a"+@-?'"2(1"6$C f'?,;-"2(>2;#$L(#"4="2G(5'-,2'(>2;#$G(;+(+,-?(>2;#$C
<,#2;A'-"#(6455;6,.;+@(MO(1?h$?R(MqO(@+R(;+(5"+"#'."1;2(MT_(1?h$?R(,A(4-='+(O(@'"+C
*;6.;5'+".,&'
*f:(5"+"#'."1;2(Q_(1?h$?
J;5,#"2(2,=;#",-'(M2,?-;#",-'R(?'2(#"-(>'("552,'=(A+'S4'-.2@(/,.8;4.('E#''=,-?(.8'(.;E,#(=;6'C
%5'#,"2(#;-6,='+".,;-6
[(+'?,;-"2(>2;#$(146.(>'(5'+A;+1'=(5+,;+(.;(.8'(64+?'+@C
N,+#41#,6,;-(,6(;-'(;A(.8'(1;6.(5",-A42(5;6.;5'+".,&'(="@(#"6'(5+;#'=4+'6](5"+'-.6(68;42=(>'(/"+-'=("-=("=&,6'=(.;("552@(.;5,#"2(?'2 +'?42"+2@("-=(#;-.,-4'(5"+"#'."1;2(A;+(6'&'+"2(="@6C
J8'+'(,6(-;(#;-6'-646("6(.;(.8'(;5.,1"2(6.+".'?@(A;+(5",-(+'2,'AC([22(1'.8;=6("+'('AA'#.,&'C(N"4="2(,6(.'#8-,#"22@('"6,'+(,-(,-A"-.6("-= 5'-,2'(>2;#$(1"@(>'(1;+'(64,.">2'(,-(#8,2=+'-(;&'+(W($?C(f,-?(>2;#$(,6(.'#8-,#"22@('"6@(,-(>;@6(?+'".'+(.8"-(W($?G(5+;=4#,-?('E#'22'-. "-=(#;-6,6.'-.("-"2?'6,"C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 D+#8,=;5'E@
*+;#'=4+' |
f'2'"6'(;A(4-='6#'-='=(.'6.,6(,-.;(6#+;.41 |
J,1' |
T_(1,- |
*",- |
mm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e,-,1"2 |
*+"#.,#"2(.'#8-,S4' %VG(ae[(m(+'?,;-"2(>2;#$
*+';5'+".,&'
!;@6G(464"22@(;&'+(Q(@'"+6(MQs(;A(5;542".,;-RC N;11;-(="@(#"6'(5+;#'=4+'C
D>.",-(#;-6'-.(A;+(6455;6,.;+@("-=(+'?,;-"2(>2;#$C(<,6#466(+,6$6("-=(#;152,#".,;-6C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-C(a"+@-?'"2(1"6$C
f'?,;-"2(.'#8-,S4'L(#"4="2G(,2,;,-?4,-"2(>2;#$(;+(2;#"2(,-A,2.+".,;-C
<,#2;A'-"#(6455;6,.;+@(MO(1?h$?R(MqO(@'"+R(;+(5"+"#'."1;2(6455;6,.;+@(MT_(1?h$?R(,A(uO(@'"+C c,&'(64552'1'-."+@(;5,;,=6(,A(,-=,#".'=C
*;6.;5'+".,&'
*f:(=,#2;A'-"#G(5"+"#'."1;2G(#;=',-'(58;658".'G("-=("-.,I'1'.,#C %5'#,"2(#;-6,='+".,;-6
[='S4".'("-"2?'6,"(,6(=,AA,#42.(,A(.8'(.'6.,6(,6(8,?8C(N"4="2(>2;#$(68;42=(>'(8,?8(&;241'(/,.8(2;/'+(#;-#'-.+".,;-(M>45,&"#",-'(_COps ,6(.8+''(5"+.6(_CQWs(>45,&"#",-'(.;(O(5"+.(6"2,-'RC([(1,=(.8;+"#,#(2'&'2(,6(;>.",-'=(A+;1(OCQW(12h$?(;A(.8,6(1,E.4+'C
KA(,2,;,-?4,-"2(>2;#$(,6(46'=G(;-2@(.8'("-.'+,;+(.8,+=(;A(.8'(6#+;.41(,6("-"'6.8'.,B'=t46'(2;#"2(,-A,2.+".,;-(A;+(.8'(6#+;."2(,-#,6,;-C J'6.,#42"+(.+"#.,;-('&'-(/,.8(6''1,-?2@("='S4".'(>2;#$"='(1"@(2'"=(.;(,-.+"I;5'+".,&'(>+"=@#"+=,"(;+(1,2=(2"+@-?;65"61('65'#,"22@ /,.8(.8'(,2,;,-?4,-"2(>2;#$C(%4+?'+@(68;42=(>'(6.;55'=("-=("-"'6.8'6,"(=''5'-'=](64552'1'-."+@(;5,;,=6(1"@(>'(+'S4,+'=C %465'#.'=(.;+6,;-(;A(.8'(.'6.,6(,6("(64+?,#"2('1'+?'-#@("-=(.8'(-''=(A;+("(+"5,=(6'S4'-#'(,-=4#.,;-(/,22(8"&'(.;(>'(#;-6,='+'=C
[-"2?'6,#(.'#8-,S4'6("+'("6(>'A;+'C
[(8,?8(.'6.,6(1"@(-''=(64+?'+@(,-(./;(6."?'6C(J8'(A,+6 .(5+;#'=4+'(,6(.;(,='-.,A@(.8'(.'6.,6("-=(,A(5;66,>2'(>+,-?(,.(=;/-(.;(.8'(,-?4,-"2 +,-?C(J8,6(,6(464"22@(5'+A;+1'=(2"5"+"6#;5,#"22@("-=(/,22(+'S4,+'(,-.4>".,;-G(#;-.+;22'=(&'-.,2".,;-(/,.8(,-.+"I;5'+".,&'(;5,;,=6G("-= +'#."2(=,#2;A'-"#(;+(5"+"#'."1;2C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 d@5;65"=,"6
*+;#'=4+' |
f'6.;+".,;-(;A(5+;E,1"2(4+'.8+"2(;5'-,-?(.;(.8'(.,5(;A(.8'(5'-,6 |
J,1' |
OPT(8 |
*",- |
mm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e,-,1"2 |
*+"#.,#"2(.'#8-,S4' %VhK**V(m(+'?,;-"2(>2;#$
*+';5'+".,&'
F64"22@("-(,6;2".'=(5+;>2'1G(>4.(.8'+'(1"@(>'("-("66;#,".,;-(/,.8(#'+.",-(+"+'(=@61;+58,#(6@-=+;1'6C
D>.",-(#;-6'-.(A;+(6455;6,.;+@("-=(+'?,;-"2(>2;#$C(<,6#466(#;152,#".,;-6("-=(+,6$6C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-C
KA(5+;#'=4+'(qO(8(46'(ae[(m(%VC
KA(5+;#'=4+'(uO(8(46'(ae[(;+(0JJ(m(K**VC
0E.'-='=(#"4="2(O(12h$?(_CQWs(>45,&"#",-'(m($'."1,-'G(#2;-,=,-'G(1;+58,-'G(;+(=,"1;+58,-'(.;(5+;2;-?(.8'(=4+".,;-(;A(.8'(>2;#$(M6'' 5C(Yp_RC
<,#2;A'-"#(6455;6,.;+@(MqO(@+R(;+(5"+"#'."1;2(MT_(1?h$?R(,A(4-='+(O(@'"+C 0152;@(8'".(#;-6'+&".,;-(1'"64+'6C
*;6.;5'+".,&'
f'?42"+(:%[K<6h5"+"#'."1;2C(N;-6,='+(1;+58,-'(:N[(M-;.("2/"@6(-'#'66"+@RC D5,;,=6(#"-(>'(46'=(,-(#"4="2(>2;#$(6,-#'(.8'(5".,'-.(/,22(>'(#".8'.'+,B'=C KA(;5,;,=(,6(46'=(,-(.8'(#"4="2(65"#'(.8'(5".,'-.(146.(>'("=1,..'=(;&'+-,?8.C
%5'#,"2(#;-6,='+".,;-6
e"@(>'(6,152'(5+;#'=4+'G('C?C(1'"."2("=&"-#'1'-.("-=(?2"-=42;52"6.@G(;+('E.'-6,&'(,-&;2&,-?(>4##"2(14#;6"(?+"A.C(J8'("-"'6.8'.,#
.'#8-,S4'(#"-(>'("=\46.'=("##;+=,-?2@C
[&;,=('+'#.,;-(/,.8(+'?,;-"2(>2;#$(5246("-("='S4".'(='5.8(;A("-"'6.8'6,"C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 N2'A.(2,5("-=(5"2".'
*+;#'=4+' |
f'5",+(;A(='A'#.(,-(455'+(2,5("-=(5"2".' |
J,1' |
OPQ(8 |
*",- |
mm |
*;6,.,;- |
%45,-'G(8'"=(+,-?G(68;42='+(6455;+. |
!2;;=(2;66 |
e,-,1"2(A;+(#2'A.(2,5C(e;='+".'(A;+(#2'A.(5"2".' |
*+"#.,#"2(.'#8-,S4' K**VC([+1;4+'=(;+(f[0(.4>'
*+';5'+".,&'
K-#,='-#'(;A(>'./''-(O(,-(T__("-=(O(,-(X__(>,+.86(>4.(#"-(>'(O(,-(QW(/8'+'(.8'+'(,6("(A"1,2@(8,6.;+@C
!;.8(2,5("-=(5"2".'("+'(,-&;2&'=(,-(W_s(;A(#"6'6C(N2'A.(5"2".'("2;-'(8"6("(8,?8(,-#,='-#'(;A("66;#,".'=("-;1"2,'6C K.(,6("-(,6;2".'=(='A'#.(,-(p_s(;A(#"6'6C
[66;#,".'=(6@-=+;1'6(;A.'-(,-&;2&'("(=,AA,#42.(",+/"@G('C?C(*,'++'Pf;>,-G(J+'"#8'+PN;22,-6G("-=(c;2='-8"+(6@-=+;1'6C(J8'+'A;+'(1"$'(" #"+'A42("66'661'-.(;A(.8'(",+/"@C
<,6#466(+,6$6("-=(#;152,#".,;-6C(D>.",-(#;-6'-.(A;+(6455;6,.;+@C
[=1,-,6 .'+(Ke(".+;5,-'(Q_(x?h$?(T_(1,-(5+';5'+".,&'2@(,A("(=,AA,#42.(",+/"@(,6(6465'#.'=C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-C(78'-(.8'+'(,6("(6465'#.'=(",+/"@(5+;>2'1G(46'(,-8"2".,;-"2(,-=4#.,;-(/,.8(6'&;A24+"-'("-=(.8'-
1",-.",-(/,.8(8"2;.8"-'C(N*[*(/,22(>'(46'A42C(K-.4>".'(=''5(/,.8(#8,2=(>+'".8,-?(65;-."-';462@(;+(A;22;/,-?(146#2'(+'2"E"-.(;-#'(" 6"A'(",+/"@(8"6(>''-('6.">2,68'=C
[(5+'A;+1'=(f[0(1"@(>'(;>6.+4#.'=(;+($,-$'=(>@(.8'(?"?G('65'#,"22@(.8'(61"22'+(6,B'6C([(+',-A;+#'=(.4>'(/,22(+'6,6.(#;15+'66,;-(>4. -''=6(.;(>'(#"+'A422@(6'#4+'=(".(#;++'#.(2'-?.8C
F6'(K**VC
F6'("(.8+;".(5"#$("-=(1"$'(64+'(.8'('@'6("+'(5+;.'#.'=C
J8'(64+?';-(464"22@(52"#'6(.8'(?"?C(0-#;4+"?'(2;#"2("-"'6.8'.,#(,-A,2.+".,;-C
H'-."-@2(QPU(x?h$?(m(6455;6,.;+@(M5"+"#'."1;2(T_(1?h$?(uO(@'"+(;+(=,#2;A'-"#(O(1?h$?(qO(@'"+R(m(2;#"2(,-A,2.+".,;-(/,.8("=+'-"2,-'C
N;=',-'(58;658".'(O(1?h$?(Ke(5+,;+(.;(+'&'+6"2C
*;6.;5'+".,&'
0E.4>".'("/"$'C(%4#.,;-(.8'(58"+@-E('"+2@("-=(#"+'A422@(.;(5+'&'-.(="1"?'(.;(.8'(+'5",+C :"6"2(.4>'6(1"@(>'(,-6'+.'=(.;(1",-.",-(5".'-#@(;A(.8'(",+/"@C([(.;-?4'(6.,.#8(,6(+"+'2@(46'=C *CZ_Z
f;4.,-'(5;6.;5'+".,&'("-"2?'6,"(.;(,-#24='(+'?42"+(5"+"#'."1;2G(=,#2;A'-"#G(;+(,>45+;A'-("-=(#;=',-'(58;658".'C
%5'#,"2(#;-6,='+".,;-6
K-.4>".,;-(,6(464"22@(4-#;152,#".'=C
J8'(2"+@-?;6#;5'(>2"='(+"+'2@(2;=?'6(,-(.8'(#2'A.C(KA(.8'+'(,6("(5+;>2'1G("(+;22(;A(?"4B'(#"-(A,22(.8'(?"5C *+;2;-?'=(64+?'+@(1"@(#"46'(6/;22'-(.;-?4'(A+;1(5+'664+'(;A(1;4.8(?"?C
7,.8(",+/"@(5+;>2'16G(;5,;,=6(68;42=(>'(?,&'-(#"4.,;462@C(*;6.;5'+".,&'(1;-,.;+,-?(68;42=(,-#24='(5426'(;E,1'.+@("-=("5-;'"("2"+1C N2'A.(2,5(,6(464"22@(+'5",+'=(".(T(1;-.86G(#2'A.(5"2".'(".(X(.;(p(1;-.86C(J8'(2,5(1"@(>'(+'5",+'=(".(.8'(-';-"."2(6."?'(.;(,15+;&'(.8' 6#"+("-=("66,6.(1".'+-"2(>;-=,-?C(J8'+'(,6(-;('&,='-#'(.;(6455;+.(.8,6C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6
N;-?'-,."2(."2,5'6('S4,-;&"+46
*+;#'=4+' |
N;++'#.,;-(;A(#24>(A;;.(">-;+1"2,.@ |
J,1' |
UW(1,-PO(8 |
*",- |
mm |
*;6,.,;- |
%45,-'G(6;1'.,1'6(5+;-'(A;+(5;6 .'+,;+(+'2'"6' |
!2;;=(2;66 |
e,-,1"2 |
%VG(ae[G(#"4="2
*+"#.,#"2(.'#8-,S4'
KA(5+;-'(.8'-(0JJ(m(K**VG(#"4="2
*+';5'+".,&'
D##4+6(,-(O(,-(O___(>,+.86C
K.(,6(464"22@("-(,6;2".'=("-;1"2@(>4.(1"@(;##4+(,-("66;#,".,;-(/,.8(6;1'(1@;5".8,#(=,6'"6'6("-=(.8'+'A;+'(.8'+'(1"@(>'("-(,-#+'"6'= +,6$(;A(1"2,?-"-.(8@5'+.8'+1,"C
D>.",-(#;-6'-.(A;+("(6455;6,.;+@("-=(+'?,;-"2(>2;#$C(<,6#466(+,6$6("-=(#;152,#".,;-6C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-(/,.8(ae[C(KA(5+;-'(,-.4>".'("-=(&'-.,2".'C(c,&'("==,.,;-"2(;5,;,=6(,A(,-=,#".'=C
N"4="2(>2;#$"='L(O(12h$?(_CQWs(>45,&"#",-'C
f'#."2(=,#2;A'-"#(O(1?h$?(MqO(@'"+RG(+'#."2(5"+"#'."1;2(T_(1?h$?(,A(uO(@'"+C
*;6.;5'+".,&'
c,&'(+'?42"+(=,#2;A'-"#G(5"+"#'."1;2G(#;=',-'(58;658".'(m("-.,I'1'.,#(A;+(.8'(A,+6.(="@C(D+"1;+58(1"@(>'("(46'A42("2.'+-".,&'C %5'#,"2(#;-6,='+".,;-6
H;+(5+;2;-?'=(5",-(+'2,'A(',.8'+(.;5I45(.8'(#"4="2(".(.8'('-=(;A(.8'(5+;#'=4+'(>@(46,-?("-(,-=/'22,-?(QQc(;+(Q_c(#"--42"(;+('E.'-=(.8'
=4+".,;-(;A(.8'(>2;#$(>@("==,-?(5+'6'+&".,&'IA+''($'."1,-'(M_CW(1?h$?R(.;(.8'(,-,.,"2(=;6'(;A(>45,&"#",-'C(<,"1;+58,-'("-=(#2;-,=,-'(/,22("26; 'E.'-=(.8'(>2;#$C(d;/'&'+G(.8'(A;+1'+(1"@(2'"=(.;(4+,-"+@(+'.'-.,;-("-=(.8'(2"..'+(,-"55+;5+,".'(2'&'26(;A(=+;/6,-'66C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 H'1;+"2(;6.';.;1@
*+;#'=4+' |
%.">,2,B,-?(.8'(8,5(,-(#;-?'-,."2(=,62;#".,;-(>@(1"$,-?("(#4.(.8+;4?8(.8'(5+;E,1"2(A'14+ |
J,1' |
Q(8 |
*",- |
mmm |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
e;='+".'h5;.'-.,"22@(2"+?' |
*+"#.,#"2(.'#8-,S4' %V(m(ae[(;+(K**V(m(#"4="2h'5,=4+"2
*+';5'+".,&'
F64"22@("-(,6;2".'=(='A'#.C(N;11;-'+(,-(?,+26(;+(/8'+'(.8'+'(,6("(A"1,2@(8,6.;+@C
D>.",-(#;-6'-.(A;+("(6455;6,.;+@("-=(+'?,;-"2(>2;#$C(<,6#466(+,6$6G(#;152,#".,;-6C
*'+,;5'+".,&'
K-8"2".,;-"2(;+(KV(,-=4#.,;-C(%V(;+(K**V(/,.8(ae[(;+(,-.4>".'(m(K**V(,A(uO_($?C
N"4="2(>2;#$(m(5+'6'+&".,&'IA+''($'."1,-'(;+(#2;-,=,-'C([&;,=(#"4="2(;5,;,=6(>'#"46'(;A(.8'(+,6$(;A(4+,-"+@(+'.'-.,;-C([2.'+-".,&'2@(?,&' "(241>"+('5,=4+"2C(K-.+";5'+".,&'(;5,;,=6(1"@(>'(46'A42C
0152;@(8'".(#;-6'+&".,;-(1'"64+'6C [..'-.,;-(.;(>2;;=(2;66C
*;6.;5'+".,&'
0E.'-='=(#"4="2(;+(1;+58,-'(:N[(/,.8(+'?42"+(:%[K<6(;+(5"+"#'."1;2C(N;-6,='+('-.'+"2(1;+58,-'(5+'5"+".,;-C [(8,5(65,#"(5+;&,='6(6455;+.("-=(8'256(/,.8(5",-(+'2,'AC
%5'#,"2(#;-6,='+".,;-6
!2;;=(2;66(1"@(>'('E.'-6,&'(,A(,.(,6(+'5'".(64+?'+@C [(8,5(65,#"(#;152,#".'6(4+,-"+@(+'.'-.,;-(,-(?,+26C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 K-8"2'=(A;+',?-(>;=@
*+;#'=4+' |
f'1;&"2(;A(A;+',?-(>;=@(A+;1(>+;-#8,"2(.+'' |
J,1' |
T_(1,- |
*",- |
m |
*;6,.,;- |
%45,-' |
!2;;=(2;66 |
:,2 |
*+"#.,#"2(.'#8-,S4' %V(;+(K**V
*+';5'+".,&'
J8'(#;11;-'6.(+'"6;-(A;+(>+;-#8;6#;5@(,-(.8'(OPT(@'"+("?'(?+;45C
[(A;+',?-(>;=@(,-(.8'(455'+(",+/"@6(1"@(5+'6'-.("6("-('1'+?'-#@("#4.'(",+/"@(;>6.+4#.,;-C
D>6.+4#.,;-(;A(.8'(2;/'+(",+/"@6(1"@(A;22;/("(8,6.;+@(;A(#;4?8,-?("A.'+(6'&'+"2(="@6C(*'"-4.(;,2(,6("-(,++,."-.("-=(2'"=6(.;(14#;6"2 ;'='1"("-=(#8'1,#"2(5-'41;-,.,6C([(#8'6.(+"=,;?+"58(68;/6(#8"+"#.'+,6.,#(8@5'+,-A2".,;-(=4+,-?('E5,+".,;-G(>4.(.8'(A;+',?-(>;=@(,6 -;.(464"22@(&,6,>2'C
J+'".(6@15.;16("6(,-=,#".'=G('C?C(='8@=+".,;-G(5-'41;-,"G(/8''B'C
D>.",-(#;-6'-.G("-=(=,6#466(+,6$6("-=(#;152,#".,;-6C
*'+,;5'+".,&'
K-8"2".,;-"2(,-=4#.,;-(,6(464"2(.;("&;,=(5468,-?(.8'(;>\'#.(A4+.8'+(,-tO__s(;E@?'-(/,.8(6'&;A24+"-'(;+(8"2;.8"-'C <''5(,-8"2".,;-"2(1",-.'-"-#'(/,.8(8"2;.8"-'(M6'&;A24+"-'(?,&'6(.;;(+"5,=("-("/"$'-,-?RC
[552@(.;5,#"2("-"'6.8'6,"(.;(.8'(&;#"2(#;+=6(MQs(2,=;#",-'(M2,?-;#",-'RR("-=(#;-6,='+("(=+@,-?("?'-.C f,?,=(>+;-#8;6#;5@P.8'(%.;+B(>+;-#8;6#;5'(8"6(".."#81'-.(A;+("(JI5,'#'C
KA(.8'(A;+',?-(>;=@(,6(,-(.8'(2;/'+(",+/"@G(.8'-(46'(K**V(/,.8("(146#2'(+'2"E"-.(6,-#'(.8'(;>\'#.(/,22(>'(5468'=(=,6."22@(>@(.8' >+;-#8;6#;5'(4-.,2(,.(#"-(>'(?+"65'=(>@(A;+#'56C(c,&'("66,6.'=(&'-.,2".,;-(&,"("(JI5,'#'(;+(8,?8A+'S4'-#@(\'.(&'-.,2".,;-C J8,6(1"@(>'("(=,AA,#42.(5+;#'=4+'C
*;6.;5'+".,&'
KA(>+;-#8;6#;5@(,6(.+"41".,#G(?,&'(='E"1'.86;-'(_CQW(1?h$?(KV(.8'-(./;(=;6'6(ZI8;4+2@(;A(_COQW(1?h$?C
N;-6,='+(58@6,;.8'+"5@("-=("-.,>,;.,#6("6(,-=,#".'=C
%5'#,"2(#;-6,='+".,;-6
KA(.+"#8'"2(;+(>"22I&"2&'(;>6 .+4#.,;-(,6(6465'#.'=G(K**V(,6(#;-.+",-=,#".'=C
K-.4>".,;-(1"@("66,6 .(24-?(&'-.,2".,;-("-=(6,B,-?(;A(.8'(>+;-#8;6#;5'(,A("(.+"#8'"2(A;+',?-(>;=@(,6('E#24='=C
