[Keith Allman] Oxford Handbook Of Anaesthesia
.pdf
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 H",2'=(,-.4>".,;-
<'A,-'=("6(=,AA,#42.@(,-(&,'/,-?(.8'(2"+@-EG(#"46,-?(A",24+'(.;(,-.4>".'(.8'(.+"#8'"C(f'1'1>'+(.8".(5".,'-.6(=;(-;.(=,'(A+;1(A",24+'(.;(,-.4>".' >4.(A",24+'(.;(;E@?'-".'C
J8'(#2,-,#"2(6#'-"+,;(='.'+1,-'6(.8'(>'6.(1"-"?'1'-.L
KA(.8'(5".,'-.(8"6("(A422(6.;1"#8("-=(,6(4-='+?;,-?("(+"5,=(6'S4'-#'(,-=4#.,;-(.8'-(,.(,6(>'6.(.;(,-6.,.4.'("(A",2'=(,-.4>".,;-(=+,22('"+2@ "-=(/"$'(.8'(5".,'-.(45C(f"+'2@(.8'+'("+'(#2,-,#"2(6,.4".,;-6(M'C?C(,-(;>6 .'.+,#6R(/8'+'(@;4(1"@(='#,='(.;(5+;#''=(/,.8(64+?'+@(4-='+ 1"6$("-"'6.8'6,"C
K-("-('2'#.,&'(#"6'G(/8'-(.8'(5".,'-.(8"6(+'#',&'=("(A422(=;6'(;A("(-;-='5;2"+,B,-?(146#2'(+'2"E"-.("-=(1"6$(&'-.,2".,;-(,6('"6@G(,. 1"@(>'("55+;5+,".'(.;(.+@("(A422(+"-?'(;A(.'#8-,S4'6(M6''(H,?C(TYCTRC
*;66,>2'(6.+".'?,'6(,-("(#"6'(;A(=,AA,#42.(,-.4>".,;-
D5.,1,B'(.8'(5;6,.,;-(;A(.8'(8'"=(MA2'E,;-(;A(.8'(#'+&,#"2(65,-'(/,.8(1"E,1"2('E.'-6,;-(".(.8'(#+"-,;#'+&,#"2(\4-#.,;-RC d"&'(=,AA'+'-.(2"+@-?;6#;5'(>2"='6("&",2">2'C(J8'(e#N;@(>2"='(/,.8("(A2'E,-?(.,5(#"-(>'(5"+.,#42"+2@(8'25A42C
e"-,542".,;-(;A(.8'(2"+@-E(>@(.8'("66,6."-.C
F6'("(?41('2"6.,#(>;4?,'(Mk06#81"--(.+"#8'"2(.4>'(,-.+;=4#'+(M+'46">2'RlG(%,16(*;+.'E(a.=G(:'/(*;+.'E(d;46'G(e,2,."+@(f;"=G(d@.8'G(^'-. NJQO(W!:G(F^G(.'2L(_OT_T(QX_WWORC(J8,6(,6(5+;>">2@(.8'(1;6.(46'A42(5,'#'(;A('S4,51'-.(A;+("-@(4-'E5'#.'=(=,AA,#42.(,-.4>".,;-C(^''5(.8' >;4?,'(/'22("-.'+,;+(.;('-64+'(,.(=;'6(-;.('-.'+(.8'(;'6;58"?46G("-=(,-(.8'(1,=2,-'(.;("&;,=(+,?8.(;+(2'A.(5@+,A;+1(A;66"'C(p_‚(#;4-.'+ #2;#$/,6'(+;.".,;-(;A(.8'(.4>'(",=6(64##'66A42(+",2+;"=,-?(;-#'(.8'(>;4?,'(,6(,-(5;6,.,;-C
N;-6,='+("2.'+-".,&'(,-.4>".,-?(.'#8-,S4'6(M,-.4>".,-?(ae[G(N;1>,.4>'G(A,>+';5.,#(6#;5'G(+'.+;?+"='(1'.8;=6RC
7,.8(">-;+1"2("-".;1@(.8'(#;+=6(1"@(>'(=,AA,#42.(.;(6''C(*+'664+'(;-(.8'(#8'6.(1"@(5+;=4#'("(>4>>2'(".(.8'(2"+@-?'"2(;5'-,-?C
<,"?-;6,6(;A(1,652"#'1'-.
f'.",-("(8,?8(,-='E(;A(6465,#,;-("A.'+("(=,AA,#42.(,-.4>".,;-C
%465'#.(;'6;58"?'"2(52"#'1'-.(,A(@;4(#"--;.(#;-A,+1L(-;+1"2(>+'".8(6;4-=6(,-(>;.8("E,22"'("-=(">6'-.(6;4-=6(;&'+(.8'(6.;1"#8](+,6' "-=(A"22(;A(#8'6.](-;+1"2(0JNDQ(.+"#'](-;+1"2(",+/"@(5+'664+'(#@#2'C
J8'(.+"#8'"(,6("(+,?,=(6.+4#.4+'G(.8'(;'6;58"?46(,6(-;.C(KA(-'?".,&'(5+'664+'(,6("552,'=(.;(.8'(0JJG(A",24+'(.;("65,+".'(",+(M'C?C(/,.8(" >2"=='+(6@+,-?'(=,+'#.2@(".."#8'=(.;(.8'(0JJR(64??'6.6(;'6;58"?'"2(52"#'1'-.C
N;-A,+1(0JJ(52"#'1'-.(/,.8("(A,>+';5.,#(6#;5'C
f'1'1>'+P,A(,-(=;4>.G(5422(,.(;4.("-=("552@(>"?("-=(1"6$(&'-.,2".,;-C
J8'(,-.4>".,-?(2"+@-?'"2(1"6$(",+/"@(MKae[R
K-.4>".,;-(&,"(.8'(2"+@-?'"2(1"6$(",+/"@(1"@(>'(5'+A;+1'=(>2,-=G(",='=(>@("(A,>+'6#;5'G(;+(",='=(&,"("(&"+,'.@(;A(;.8'+(1'.8;=6 M?4,='/,+'G(>;4?,'G(2,?8./"-=RC
H,?(TYCT(H",2'=(,-.4>".,;-C
V,'/(H,?4+'
*CZYW
J8'(Kae[(MK-."&'-.R(,6("(1;=,A,#".,;-(;A(.8'(ae[(='6,?-'=(.;(A"#,2,.".'(>2,-=(;+;.+"#8'"2(,-.4>".,;-G(A,>+';5.,#(,-.4>".,;-G(;+(,-(&'+@
#;;5'+".,&'(5".,'-.6("/"$'(,-.4>".,;-C
K.(A'".4+'6("(+,?,=("-".;1,#"22@(#4+&'=(",+/"@(.4>'(.'+1,-".,-?(,-("(6."-="+=(OW(11(#;--'#.;+C(K.(,6(A,..'=(/,.8("(+,?,=(1'."2(8"-=2'C
F-2,$'("(6."-="+=(2"+@-?'"2(1"6$G(,.(8"6("(6,-?2'('5,?2;..,#('2'&".,-?(>"+(+'52"#,-?(.8'(./;(>"+6(;A("(6."-="+=(ae[C(J8'(#"4="2('-=(;A
.8'(>"+(,6(-;.(A,E'=(.;(.8'(1"6$(A2;;+("22;/,-?(,.(.;('2'&".'(.8'('5,?2;..,6(/8'-("-('-=;.+"#8'"2(.4>'(,6(5"66'=(.8+;4?8(.8'("5'+.4+'C K.(#;1'6(,-(.8+''(6,B'6L
6,B'(T(A;+("(61"22("=42.(;+(2"+?'(#8,2=
6,B'(U(A;+("(-;+1"2("=42.
6,B'(W(A;+("(2"+?'("=42.C
[22(.8+''(6,B'6(/,22("##'5.("(.4>'(;A(45(.;(Z(11(,-.'+-"2(=,"1'.'+C
K.(,6(='6,?-'=(.;(>'(46'=(/,.8("(6.+",?8.(6,2,#;-'(/,+'I+',-A;+#'=(#4AA'=('-=;.+"#8'"2(.4>'(-;.('E#''=,-?(Z(11(,-.'+-"2(=,"1'.'+ #"5">2'(;A(>',-?(5"66'=(.8+;4?8(.8'(Kae[(,-#24=,-?(.8'(5,2;.(>"22;;-("-=(5,2;.(>"22;;-(&"2&'C(J8'(.4>'(8"6("-(".+"41".,#(.,5(.; 1,-,1,B'(.8'(+,6$(;A(58"+@-?'"2(.+"41"C
J8'(.4>'(1"@(>'(5"66'=(,-.;(.8'(.+"#8'"(>2,-=2@(;+(4-='+(=,+'#.(&,6,;-(46,-?("(64,.">2'(A,>+';5.,#(6#;5'C
K.(,6(+'#;11'-='=(.8".(.8'(Kae[(,6(+'1;&'=(;-#'(.8'(.4>'(,6(5"66'=(,-.;(.8'(.+"#8'"C
*CZYX
[(6.">,2,B,-?(+;=(,6("&",2">2'(.;($''5(.8'(.+"#8'"2(.4>'(,-(52"#'("-=(62,='(.8'(Kae[(;4.(;A(.8'(1;4.8C
J8'(N;1>,.4>'
J8'(N;1>,.4>'Œ(M%8'+,="-(N".8'.'+(N;+5;+".,;-R(,6("-(",+/"@(='&,#'(.8".(#;1>,-'6(.8'(A4-#.,;-6(;A("-(;'6;58"?'"2(;>.4+".;+(",+/"@ "-=("(#;-&'-.,;-"2('-=;.+"#8'"2(",+/"@C
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6
0E.4>".,;-(;A(.8'(5".,'-.(/8;(8"6(>''-(=,AA,#42.(.;(,-.4>".'
H;22;/,-?(142.,52'("..'15.6(".(,-.4>".,;-(.8'(",+/"@(1"@(>'(;'='1".;46("-=(>2;;=@C(D-(;##"6,;-6G("-('2'#.,&'(.+"#8';6.;1@(1"@(>' -'#'66"+@C
D5.,1,B'(.8'(5".,'-.96(1'=,#"2(#;-=,.,;-L
[65,+".'(6'#+'.,;-6G("=1,-,6.'+(>+;-#8;=,2".;+6C
0-64+'(-;+1;&;2"'1,"C([..'-4".'(.8'(#"+=,;&"6#42"+(6.+'66('AA'#.6(;A('E.4>".,;-C(061;2;2(1"@(>'(46'A42C
e,-,1,B'(6.;1"#8(#;-.'-.6(,A(5;66,>2'C
N"-(",+/"@(;'='1"(>'(1,-,1,B'=z(*;6,.,;-(.8'(5".,'-.(8'"=(45C(N;-6,='+(.8'(46'(;A(,-.+"&'-;46(='E"1'.8"6;-'(;+(-'>42,B'= "=+'-"2,-'C
0-64+'(.8'+'(,6(-;(+'6,=4"2(146#42"+(5"+"2@6,6C
D5.,1,B'(5;6,.,;-(A;+('E.4>".,;-L
N;-6,='+(6,..,-?(.8'(5".,'-.(45(.;(1"E,1,B'(.8'(HfN("-=(1,-,1,B'(",+/"@(;>6.+4#.,;-C
[,=6(.;('E.4>".,;-L
N;-6,='+('E.4>".,;-(;&'+("(\'.(6.@2'.(MN;;$(",+/"@('E#8"-?'(#".8'.'+RG("(-"6;?"6.+,#(.4>'G(;+("(A,>+';5.,#(6#;5'(.8+;4?8(/8,#8 ;E@?'-(#"-(>'(64552,'=C
N;-6,='+("(.;-?4'(6.,.#8(.;(5422(.8'(.;-?4'(A;+/"+=(,A(;>6.+4#.,;-(/,.8(.8'(.;-?4'(,6(2,$'2@(.;(>'("(5+;>2'1
[(-"6"2(",+/"@(M;+(#4.(-"6;.+"#8'"2(.4>'R(1"@(8'25(5+'&'-.(;>6.+4#.,;-C d"&'("(>"#$(45(52"-L
ae[
N;1>,.4>'
#+,#;.8@+;,=;.;1@C
H4+.8'+(+'"=,-?
<@6;-([G(K6""#(*[G(*'--"-.(3dG(c,'6'#$'([dG(a,5.;-(3e(MOpp_RC(061;2;2("..'-4".'6(.8'(#"+=,;&"6#42"+(+'65;-6'6(.;('E.4>".,;-C([-"'6.8'6,"("-= [-"2?'6,"G(YOG(XYWPZC
a,>+"+@(d;2=,-?6 !,>2,;?+"58,#(a,-$6
d"+.2'@(eG(V"4?8"-(fe(MOppTRC(*+;>2'16("66;#,".'=(/,.8('E.4>".,;-C(!+,.,68(3;4+-"2(;A([-"'6.8'6,"G(YOG(WXOPZC a,>+"+@(d;2=,-?6
!,>2,;?+"58,#(a,-$6
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6
K-8"2".,;-"2(,-=4#.,;-
N;11;-(,-=,#".,;-6(A;+(,-8"2".,;-2(,-=4#.,;-(,-#24='L
>">,'6("-=(@;4-?(#8,2=+'- -''=2'(58;>,#("=42.6
"#4.'(455'+(",+/"@(;>6.+4#.,;-(=4'(.;(2'6,;-6(,-("-=("+;4-=(.8'(2"+@-EG('C?C("#4.'('5,?2;..,.,6G(5'+,2"+@-?'"2(.41;4+6 >+;-#8;52'4+"2(A,6.42"
-;('"6,2@("##'66,>2'(&',-6C
KA(5;66,>2'('E52",-(.8'(5+;#'=4+'(.;(.8'(5".,'-.(".(.8'(5+';5'+".,&'(&,6,.C
e"6$6(/,.8(,-.'?+"2(.''.6("+'(46'A42(,-(>">,'6(/8;("+'(6.,22(64#$2,-?C(K-(;2='+(#8,2=+'-(46'(;A("(#455'=(8"-=("+;4-=(.8'(A+'68(?"6(='2,&'+@
.4>'(,6(46'=C(d"2;.8"-'(;+(6'&;A24+"-'("+'(.8'(,-=4#.,;-("?'-.6(;A(#8;,#'(.;(5'+1,.(61;;.8(,-=4#.,;-(;A("-"'6 .8'6,"C(H;+(5".,'-.6(/,.8 ",+/"@(;>6.+4#.,;-(O__s(;E@?'-(,6(46'=G(;.8'+/,6'(W_s(-,.+;46(;E,='(,-(;E@?'-(,6(6".,6A"#.;+@C(78'-(46,-?(8"2;.8"-'(.8'(,-,.,"2(,-65,+'=
#;-#'-.+".,;-(68;42=(>'(Os("-=(,-#+'"6'=(,-(_CWs(,-#+'1'-.6(4-.,2(64+?,#"2("-"'6.8'6,"(,6('6.">2,68'=(M61"22(#'-.+"2(545,26("-=("(+'=4#.,;- ,-(>2;;=(5+'664+'RC(%'&;A24+"-'(#"-(>'(,-.+;=4#'=(".(UPZsC
K-(#;;5'+".,&'(5".,'-.6("(6,-?2'(>+'".8(,-=4#.,;-(.'#8-,S4'(#"-(>'(46'=C([(U(2,.+'(>"?(M;+(./;(Q(2,.+'(>"?6(,-(6'+,'6R(,6(5+'A,22'=(/,.8(8"2;.8"-' Ws(;+(6'&;A24+"-'(Zs(,-(;E@?'-C(J8'(5".,'-.('E8"2'6(A422@("-=(.8'-(."$'6("(6,-?2'(&,."2(#"5"#,.@(>+'".8("-=(,6('-#;4+"?'=(.;(>+'".8(8;2=(A;+("6 2;-?("6(5;66,>2'C(%1;;.8(,-=4#.,;-(1"@(>'("#8,'&'=(/,.8,-(T_PX_(6C
<,AA,#42.,'6(/,.8(,-8"2".,;-"2(,-=4#.,;-
%2;/(,-=4#.,;-(;A("-"'6.8'6,"C(*".,'-.6(/,.8(6 .+,=;+(8"&'(2;/("2&';2"+(1,-4.'(&;241'6C(K-=4#.,;-(;A("-"'6.8'6,"("-=(=''5'-,-?(;A
.8'("-"'6.8'.,#(/,22(>'(62;/C(%'&;A24+"-'(1"@(A",2(.;(5+;&,='("-"'6.8'6,"(;A(64AA,#,'-.(='5.8(.;("22;/(,-6.+41'-.".,;-(;A(.8'(",+/"@C [='S4".'(='5.8(;A("-"'6.8'6,"(,6(464"22@('&,='-#'=(>@("(='#+'"6'(,-(>2;;=(5+'664+'("-=(61"22(#'-.+"2(545,26C([(#8"-?'(.;(8"2;.8"-' 1"@(>'(/;+.8/8,2'C
7,.8(6.+,=;+(1",-.",-(N*[*(=4+,-?(,-=4#.,;-C
D##"6,;-"22@(",+/"@(;>6.+4#.,;-(1"@(>'(6;(6'&'+'(.8".(?"6(,-=4#.,;-(,6(-;.(5;66,>2'C(N;-6,='+(.+"#8';6.;1@(4-='+(2;#"2("-"'6.8'.,#C [,+/"@(5+;>2'16(1"@(;##4+(,-(6."?'(Q(;A("-"'6 .8'6,"(M'E#,.".,;-R(,11'=,".'2@("A.'+(.8'(5".,'-.(2;6'6(#;-6#,;46-'66C([..'15.(#8,-(2,A. "-=(\"/(.8+46.C(K-6'+.,;-(;A("-(;+"2(",+/"@(#"-(,-=4#'(#;4?8,-?("-=(2"+@-?;65"61C(N;-6,='+(.8'(46'(;A("(-"6"2(",+/"@(,-(.8'6' #,+#416."-#'6C
a"+@-?;65"61(M6''(5C(ZYQRC
!"#$ %"&'()(*+,-.(*+'&,'/()(01",2()(01",2(34156."+.
!"#$%#&'$()***
78".96(:'/(,-(!;;$6 f"5,=(6'S4'-#'(,-=4#.,;-
f"5,=(6'S4'-#'(,-=4#.,;-(,6('152;@'=(,-(.8'(5".,'-.(/,.8("(A422(6.;1"#8(/8;(+'S4,+'6(?'-'+"2("-"'6.8'6,"C(J8'(#;-#'5.(,6(2;66(;A
#;-6#,;46-'66(A;22;/'=(>@(,-.4>".,;-(,-(.8'(5+'6'-#'(;A(#+,#;,=(5+'664+'G(/,.8;4.(A"#'1"6$(&'-.,2".,;-C(KA(,-.4>".,;-(A",26(.8'(=+4?6(68;42= /'"+(;AA(+"5,=2@("-=(.8'(5".,'-.(+'6."+.(65;-."-';46(&'-.,2".,;-(>'A;+'(8@5;E,"(,-.'+&'-'6C
e'.,#42;46("66'661'-.(;A(.8'(",+/"@(,6(1"-=".;+@(5+';5'+".,&'2@(.;(2;;$(A;+(2,$'2@(=,AA,#42.,'6(/,.8(.+"#8'"2(,-.4>".,;-C(KA(5+';5'+".,&' '&"24".,;-(64??'6.6("(5+;>2'1(/,.8(,-.4>".,;-G(#;-6,='+("2.'+-".,&'(.'#8-,S4'6(64#8("6(64+?'+@(4-='+(2;#"2(;+(+'?,;-"2("-"'6.8'6,"(;+("/"$' A,>+';5.,#(,-.4>".,;-C
J8'("-"'6.8'.,6.(146.(8"&'("(1"-"?'1'-.(52"-(68;42=(,-.4>".,;-(A",2(M6''(5C(ZYURC
J'#8-,S4'
N8'#$(.8'("-"'6.8'.,#(1"#8,-'G(2"+@-?;6#;5'6G("-=(.+"#8'"2(.4>'6C
J8'(5".,'-.(146.(>'(;-("(.,55,-?(.+;22'@C
[.."#8("55+;5+,".'(1;-,.;+,-?(='&,#'6C
*;6,.,;-(.8'(5".,'-.96(8'"=("6(,A(k6-,AA,-?(.8'(1;+-,-?(",+l(M;-'(5,22;/(4-='+(.8'(8'"=G(#'+&,#"2(65,-'(A2'E'=(/,.8('E.'-6,;-(".(.8' #+"-,;#'+&,#"2(\4-#.,;-RC
[.(2'"6.(;-'(6$,22'=("66,6."-.(,6(-''='=(.;(5'+A;+1(#+,#;,=(5+'664+'C
%4#.,;-("55"+".46(,6(6/,.#8'=(;-("-=(5"66'=(4-='+(.8'(5".,'-.96(5,22;/(.;(.8'("-"'6.8'.,6 .96(+,?8.(8"-=C
*+';E@?'-".'(/,.8(O__s(;E@?'-(A;+(TPW(1,-(M;+(A;4+(&,."2(#"5"#,.@(>+'".86(/,.8(8,?8(A2;/(,-.;(.8'(#,+#4,.(,-('1'+?'-#,'6RC
[=1,-,6 .'+("(62''5(=;6'(;A(,-.+"&'-;46(,-=4#.,;-("?'-.(M.8,;5'-."2(QPW(1?h$?G('.;1,=".'(_CQP_CT(1?h$?G(5+;5;A;2(OPQ(1?h$?R(A;22;/'= ,11'=,".'2@(>@(OCW(1?h$?(;A(64E"1'.8;-,41C
[552@(#+,#;,=(5+'664+'("6(6;;-("6(#;-6#,;46-'66(,6(2;6.C K-.4>".'("6(6;;-("6(.8'(5".,'-.(+'2"E'6C
e",-.",-(#+,#;,=(5+'664+'(4-.,2(.8'(.+"#8'"2(#4AA(,6(,-A2".'=("-=(#;++'#.(52"#'1'-.(;A(.8'(.4>'(,6(#;-A,+1'=(>@(#"5-;?+"58@("-= "46#42.".,;-(;A(.8'(24-?6C
J8'(1",-(5+;>2'1(/,.8(+"5,=(6'S4'-#'(,-=4#.,;-(,6(8"'1;=@-"1,#(,-6.">,2,.@C(0E#'66,&'(=;6'6(;A(,-=4#.,;-("?'-.(1"@(+'642.(,-(#,+#42".;+@ #;22"56'(M'65'#,"22@(,A(.8'(5".,'-.(,6(8@5;&;2"'1,#RG(/8'+'"6("-(,-"='S4".'(=;6'(1"@(+'642.(,-(."#8@#"+=,"("-=(8@5'+.'-6,;-C
%5'#,"2(#;-6,='+".,;-6
J8;+;4?8(5+';E@?'-".,;-(,6('66'-.,"2C(J8'(1"6$(146.(>'(#2;6'(A,..,-?("-=(.8'(+'6'+&;,+(>"?(1;&,-?C([-@('-.+",-1'-.(;A(",+(=4+,-? 5+';E@?'-".,;-(-'?".'6(.8'(/8;2'(5+;#'66C(%."+.("?",-C
K-\'#.(=+4?6(,-.;("(+"5,=2@(+4--,-?(6"2,-'(,-A46,;-(.8+;4?8("(2"+?'(#"--42"C
K-(5".,'-.6(/8;(/,22(-;.(.;2'+".'(5+';E@?'-".,;-(M'C?C(=,6.+'66'=(#8,2=+'-R(#;-6,='+(?'-.2'(K**V("A.'+(,-\'#.,;-(;A(=+4?6C *CZZO
7,.8(5".,'-.6(,-(/8;1(8@5'+.'-6,;-("-=(."#8@#"+=,"(,6(4-='6,+">2'(M'C?C(,6#8"'1,"h8@5'+.'-6,;-R(#;-6,='+("2A'-."-,2(O_(x?h$?(O(1,- 5+,;+(.;(,-=4#.,;-("-=(A;22;/,-?(5+';E@?'-".,;-C(K-(.8'('&'-.(;A(,-.4>".,;-(A",24+'(.8,6(1"@(>'(+'&'+6'=(/,.8(-"2;E;-'(MU__(x?(KVRC
N;++'#.("552,#".,;-(;A(#+,#;,=(5+'664+'
J8'(.'#8-,S4'(;A(#+,#;,=(5+'664+'(.;(5+'&'-.(+'?4+?,.".'=(1".'+,"2('-.'+,-?(.8'(58"+@-E(/"6(='6#+,>'=(>@(%'22,#$Cp(J8,6(6,152'(1"-;'4&+' 146.(>'("552,'=(#;++'#.2@("6(,-#;++'#.("552,#".,;-(#"-(#"46'(=,AA,#42.,'6C
J8'(#+,#;,=(#"+.,2"?'(,6(8'2=(>'./''-(.8'(.841>("-=(1,==2'(A,-?'+("-=(5+'664+'(,6('E'+.'=(1",-2@(/,.8(.8'(,-='E(A,-?'+C(%;1'("4.8;+6 +'#;11'-=("(>,1"-4"2(.'#8-,S4'(/,.8(.8'(6'#;-=(8"-=(>'8,-=(.8'(-'#$C([(1,-,141(A;+#'(;A(T_(:(,6(+'S4,+'=C(N;++'#.2@("552,'=G(#+,#;,= 5+'664+'(68;42=("22;/(A"#'1"6$(&'-.,2".,;-(/,.8;4.(+,6$(;A(?"6.+,#(=,6.'-6,;-G(>4.(",+/"@(;>6.+4#.,;-(,6(5;66,>2'G(5"+.,#42"+2@(/8'-("552,'= /,.8("(5;;+(.'#8-,S4'C
H;;.-;.'
p
%'22,#$(