Books: 'Perioperative mortality'

7

Ruggeri, Laura, Giovanni Landoni, and Alberto Zangrillo. Reducing Mortality in the Perioperative Period. Springer, 2018.

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8

Devlin, H. Brendan, John N. Lunn, and N. Buck. The Report of a Confidential Enquiry into Perioperative Deaths. Nuffield Trust,The, 1987.

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9

A, Campling E., and National Confidential Enquiry into Perioperative Deaths., eds. Who operates when?: A report by the National Confidential Enquiry into Perioperative Deaths : 1 April 1995 to 31 March 1996. National Confidential Enquiry into Perioperative Deaths, 1997.

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10

Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0076.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additiona

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11

Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_001.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additiona

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12

Balik, Martin. Perioperative cardiac care of the high-risk non-cardiac patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0076_update_002.

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Non-cardiac surgery conveys a cardiac risk related to the status of the patient’s cardiovascular system. Cardiac-related risk of surgery can be assessed by integrating the risk and urgency of the procedure with cardiovascular risk factors, which include age, ischaemic heart disease, heart failure, stroke, diabetes mellitus, chronic obstructive pulmonary disease, and renal dysfunction. An individual assessment can include simple multivariate scoring systems, developed with the aim of evaluating cardiac risk prior to non-cardiac surgery. Patient assessment can be extended for indicated additiona

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13

Chen, Martin, and Muoi Trinh. Cardiogenic Shock. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0010.

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Heart failure and cardiogenic shock are important causes of perioperative morbidity and mortality that require prompt recognition prior to the institution of specialized monitoring and treatment, including the consideration of circulatory assist devices. Patients at risk for perioperative heart failure require special consideration with respect to preoperative evaluation, medical optimization prior to proceeding with surgery, and monitoring throughout the perioperative period. The intraoperative and postoperative management need to be carefully planned in order to avoid the development of acut

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14

Jenkins, Kath. Consent and anaesthetic risk. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719410.003.0002.

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This chapter describes the importance of obtaining informed consent for anaesthesia. It covers some ethical points to guide this process. Informed consent requires good knowledge of the risks of anaesthetic practice and their likelihood. The chapter contains a detailed table of perioperative adverse outcomes, linked to real-life examples to aid clarity of communication to the patient. There are detailed suggestions of how to identify the higher-risk patient and estimate their risk of perioperative mortality and morbidity.

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15

Jenkins, Kath. Consent and anaesthetic risk. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198719410.003.0002_update_001.

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This chapter describes the importance of obtaining informed consent for anaesthesia. It covers some ethical points to guide this process. Informed consent requires good knowledge of the risks of anaesthetic practice and their likelihood. The chapter contains a detailed table of perioperative adverse outcomes, linked to real-life examples to aid clarity of communication to the patient. There are detailed suggestions of how to identify the higher-risk patient and estimate their risk of perioperative mortality and morbidity.

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16

Moore, Laurel E. Acute Stroke. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0063.

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Stroke is the leading cause of disability in the United States, and in terms of mortality is second only to ischemic heart disease worldwide. Medical management for acute ischemic stroke (AIS) was limited to supportive care until 1995, when the National Institute of Neurological Disorders and Stroke (NINDS) trial demonstrated improved outcomes with systemic thrombolysis for AIS. Since December 2014, four major articles have been published in support of endovascular intervention for AIS, making this a central focus of this chapter. Other related topics for this chapter include the timing of ele

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17

Clarkin, Andrew J., and Nigel R. Webster. Pre-surgical optimization of the high-risk patient. Edited by Neil Soni and Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0088.

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There is a small group of patients undergoing surgery who comprise the majority of perioperative deaths. Morbidity and mortality resulting from tissue hypoxia in the perioperative period can be predicted and prevented by identification of the at-risk group and targeted interventions. Management of these patients requires an understanding of oxygen delivery, the use of cardiac output monitoring to guide fluid and inotrope administration to attain a predefined goal of supranormal oxygen delivery, and the attainment of physiological goals. There are both patient outcome and economic benefits to t

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18

Williams, Erin S. Pulmonary Hypertension. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0029.

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Pulmonary hypertension is one of the most challenging medical conditions for even the most experienced anesthesiologist to manage. The very dynamic nature of pulmonary vascular disease lends itself to potential catastrophic changes that can increase the perioperative morbidity and mortality. Given the potential for significant hemodynamic, oxygenation, and ventilation changes during perioperative care it is imperative that the pediatric anesthesiologist not only perform a history and physical exam in this high-risk patient population but also carefully evaluate the most recent cardiac studies

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19

Gottlieb, Erin A., and David F. Vener. Single-Ventricle Physiology. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0026.

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Pediatric and adult patients with single ventricle physiology may present for elective and emergent procedures, and it is critical for pediatric anesthesiologists to be familiar with the stages of palliation. In addition, basic knowledge of how to manage each stage perioperatively is required to avoid morbidity and mortality. This chapter describes the anatomy and physiology of and ventilation and oxygenation strategies for each stage of single ventricle palliation. It also discusses the risks associated with anesthetizing the single-ventricle patient with a modified Blalock-Taussig shunt, the

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20

van Lier, Felix, and Robert Jan Stolker. Preoperative assessment and optimization. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0040.

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Perioperative cardiovascular complications (including myocardial ischaemia and myocardial infarction) are the predominant cause of morbidity and mortality in patients undergoing non-cardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischaemia due to the stress of surgery in the presence of a haemodynamically significant coronary lesion, leading to subendocardial ischaemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events. Perioperative management aims at optim

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21

Hardacker, Doris M. Cushing’s Disease. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0029.

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Cushing’s syndrome is caused by adrenocorticotropic hormone (ACTH)-secreting or cortisol-secreting tumors. In most cases, the hypercortisolism is caused by an ACTH-secreting tumor of the pituitary. An excess of circulating cortisol adversely affects all major organ systems, including the cardiovascular system and therefore produces a wide range of clinical features. Perioperative morbidity and mortality will largely be determined by the magnitude of cardiac dysfunction encountered. Successful perioperative management depends on a thorough preoperative assessment of affected organs, comprehensi

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22

Hert, Stefan De, and Patrick Wouters. Heart disease and anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0083.

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Cardiovascular disease is a leading cause of mortality. Hypertension is one of the major risk factors for cardiovascular disease. Classically, hypertension is subdivided according to the aetiology into primary and secondary hypertension. Ischaemic heart disease constitutes a major concern for perioperative morbidity and mortality. Therefore important efforts are directed towards the identification of the patient at risk for perioperative cardiac complications and towards optimization of the cardiac status before intervention. Cardiac rhythm disturbances fall into two general classes: bradyarrh

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23

Bennett, Jeremy, and Kara Siegrist. Myocardial Ischemia. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0005.

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Coronary artery disease is a prevalent and growing problem in the United States leading to significant morbidity and mortality including myocardial ischemia and infarction. Diagnosis and treatment of myocardial ischemia under general anesthesia can present unique challenges for the anesthesiologist including interpretation of diagnostic monitoring data and options for therapeutic interventions. There are many complex factors that determine myocardial oxygen supply and demand; when these become imbalanced, myocardial ischemia occurs that can progress to infarction. Maintaining a high-degree of

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24

Brown, Jeremiah R., and Chirag R. Parikh. Cardiovascular surgery and acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0245.

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Over the last decade, cardiac surgery-associated acute kidney injury (AKI) has been recognized as a frequent adverse event following cardiac surgery. In this clinical context and others, AKI has been strongly associated with increased morbidity, mortality, and length of hospitalization. These adverse events that accompany AKI have been shown to be directly proportional to the magnitude of the peak rise in serum creatinine and the duration of AKI making AKI a costly complication and a target for prevention in hospitalized patients around the world. This chapter discusses the subsequent healthca

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25

Peeran, Syed M. Combined Endovascular and Surgical Retrograde Superior Mesenteric Artery Recanalization. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0027.

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Acute mesenteric ischemia is a life-threatening vascular emergency associated with a very high mortality rate. In the setting of necrotic bowel, the current standard of care requires a laparotomy with bowel resection and surgical or endovascular revascularization of the superior mesenteric artery. Unfortunately, mesenteric bypass confers high perioperative mortality, in some reports up to 45%. A hybrid technique that employs an exploratory laparotomy, catheterization of the distal superior mesenteric artery, and stent deployment across the atherosclerotic lesion was first described in 2004 for

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26

Freely Jr, John J., and Michel Sabbagh. Pyloric Stenosis. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0083.

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Pyloric stenosis is one of the most common surgical conditions affecting neonates and young infants. Hypertrophy of the pyloric muscular layers results in gradual gastric outlet obstruction. Persistent episodic projectile vomiting and dehydration as well as hypochloremic, hypokalemic metabolic alkalosis are cardinal features. Definitive treatment is surgical pyloromyotomy, but it is not a surgical emergency. Emergency medical intervention is often required to correct intravascular volume depletion and electrolyte disturbances. Morbidity and mortality should be limited due to advancements in su

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27

Chen, Grace, and Ashley Valentine. Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0007.

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Neuraxial anesthesia and analgesia are effective modalities for surgery and perioperative pain management, respectively. These techniques may have nonanalgesic benefits as well, including improved 30-day mortality benefit, decreased risk of perioperative pneumonia, decreased risk of persistent postoperative pain, and attenuation of the stress response to surgery with improved survival in certain cancers. Post-operative pain control with epidural can be especially beneficial for opioid tolerant chronic pain patients compared to enteral or parenteral analgesics alone. In patients with previous b

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28

Kreeger, Renee Nierman, and James P. Spaeth. Muscular Dystrophy. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0063.

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Gastrostomy tube placement is typically a routine surgical procedure with little concern for morbidity and mortality. However, in patients with Duchenne muscular dystrophy (DMD), this is not the case. Patients with DMD present a unique clinical dilemma since they often do not require gastrostomy tube placement until their physical status has deteriorated to the point that they have respiratory insufficiency or failure and clinically significant cardiomyopathy. An understanding of the pathophysiology of this disorder and a proactive approach to perioperative management are important to ensure a

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Fawcett, William J. Anaesthesia for abdominal surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0061.

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Care of patients undergoing major gastrointestinal surgery has been revolutionized in the last decade. The widespread adoption of laparoscopic surgery has bought benefits but also new challenges. Anaesthetic techniques, particularly refinements in analgesic regimens and fluid management, have also brought benefits to patients. However, many more elderly and frail patients are undergoing major surgery which is a challenge in both expertise and resources. Anaesthesia for patients undergoing gastrointestinal surgery has evolved into a package of perioperative care, with the anaesthetist increasin

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Mitchell, John D., and Marek Brzezinski. Introduction to Pulmonary Urgencies and Emergencies. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0013.

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The lungs exchange gases and also provide for some metabolic functions. Respiratory failure can be grouped into types I-IV. Type I (hypoxemic) and type II (hypercapnic) are the most prominent; type III is perioperative and often considered a subset of type I, while type IV is due to shock. Pulmonary urgencies and emergencies require rapid diagnosis and treatment in order to avoid morbidity and mortality. Identification of risk factors for desaturation and the application of an appropriate management algorithm can facilitate diagnosis and management. The ABCD-A SWIFT CHECK algorithm and its sub

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31

Wang, Cynthia, and Michelle Y. Braunfeld. Acute Liver Failure. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0035.

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Acute liver failure produces widespread physiologic derangements including encephalopathy, coagulopathy, peripheral vasodilation, a systemic inflammatory response, and multiorgan failure. Morbidity is significant, and mortality is 50%. The classification of liver failure and the various etiologies, including viral hepatitis, drug-induced, toxins, and autoimmunity are reviewed here. The multisystem effects of acute liver failure influence all aspects of perioperative care and adequate supportive care during this time is crucial to providing the best possible outcome for the patient. Specific tr

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32

Wyatt, Karla E. K., and Olutoyin A. Olutoye. Exploratory Laparotomy for Necrotizing Enterocolitis. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0046.

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Necrotizing enterocolitis (NEC) is a severe inflammatory bowel disease that commonly affects premature infants. The pathogenesis is multifactorial and poorly understood, although certain risk factors have been identified. This disease, more commonly detected in premature infants with accompanying cardiac and pulmonary comorbid conditions, is associated with increased morbidity and mortality. Multiorgan system homeostasis becomes critical for the pediatric anesthesiologist when approaching medical and surgical interventions for affected patients. This chapter focuses on the population at risk f

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Dierdorf, Stephen F. Porphyria. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0026.

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Heme, and iron containing compound that forms the nonprotein portion of hemoglobin, is essential to life. Heme synthesis requires eight enzymatic steps, and a deficiency in any one of the eight enzymes can lead to the accumulation of potentially toxic intermediates. Some forms of porphyria may be asymptomatic until the patient receives a triggering agent, and acute porphyrias can also be difficult to diagnose because of the nonspecific clinical features. The most serious of the clinical manifestations is severe neurologic dysfunction. An attack can be triggered by medications administered duri

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Sjoblom, Matthew D., Diane Gordon, and Lori A. Aronson. Hypopituitarism. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0041.

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Hypopituitarism is a decreased secretion of pituitary hormones. It is especially concerning during surgery and anesthesia if it results in adrenal insufficiency, hypothyroidism, or diabetes insipidus. Common causes in children include pituitary tumor and/or treatment, traumatic brain injury, and empty sella syndrome. Perioperative management includes recognition of clinical symptoms, such as hypotension, fatigue, polydipsia, and increased urine output. Unrecognized adrenal insufficiency may result in significant morbidity or mortality. Intraoperative treatment may involve stress-dose corticost

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35

Hopkins, Philip M. Adverse drug reactions in anaesthesia. Edited by Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0022.

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Adverse drug reactions are implicated in more than 40% of anaesthesia-related deaths. Undoubtedly, many more patients experience morbidity from adverse drug reactions. Widely cited definitions of adverse drug reactions encompass common side-effects but this chapter focuses on those that are unexpected reactions to drugs administered by anaesthetists and that occur at normal drug doses. The chapter includes a comprehensive account of malignant hyperthermia, which remains a major contributor to anaesthesia related to deaths. Malignant hyperthermia is a pharmacogenetic condition triggered by pote

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36

Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for major abdominal surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0008.

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Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should

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37

AlJaroudi, Wael. Risk Assessment Before Noncardiac Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0014.

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Perioperative risk assessment is essential in screening patients before noncardiac surgery. Cardiovascular complications such as fatal and non-fatal myocardial infarction (MI), ventricular arrhythmia, pulmonary edema, and stroke are important in-hospital causes of morbidity and mortality intra and post-operatively. The optimal approach is to identify patients at increased risk so that appropriate testing and therapeutic interventions are undertaken a priori to minimize such risk. The initial preoperative evaluation includes identification of surgery-specific risk, patient exercise functional c

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38

Biertho, Laurent, Maud Robert, and Picard Marceau. Prevention and Management of Complications in Biliopancreatic Diversion with Duodenal Switch. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0034.

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This chapter summarizes the early postoperative and long-term complications of biliopancreatic diversion with duodenal switch (BPD-DS) procedures. Perioperative mortality for BPD-DS is currently around 0.1%, with an early complication rate of 7%. The standard follow-up required for the prevention of nutritional deficiencies as well as the management of short- and long-term complications specific to metabolic surgeries are also discussed. The data and clinical views expressed in this chapter are based to a large extent on the authors’ experience with 5,000 BPD-DS surgeries in our institution ov

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39

Pearce, F. Ben, Tze-Woei Tan, and Wayne W. Zhang. Endovascular Aneurysm Repair versus Open Repair in Patients with Abdominal Aortic Aneurysm. Edited by SreyRam Kuy, Wayne Zhang, and Tze-Woei Tan. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0003.

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This chapter provides a summary of the landmark EVAR Trial 1, which compared endovascular repair of abdominal aortic aneurysms (AAA) with open repair in patients judged to be fit for both open and endovascular repair. Although endovascular AAA (EVAR) repair was associated with lower perioperative complications and mortality than open surgical repair, after 4 years of follow-up the outcomes of the two approaches were similar. Follow-up at 15 years found EVAR had inferior late survival, necessitating lifelong surveillance of EVAR and reintervention if necessary. The chapter describes the basics

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40

Abatzis, Vaia T., and Edward C. Nemergut. Transsphenoidal/Pituitary Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0004.

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Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic a

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Pisklakov, Sergey, Haitham Ibrahim, and Ingrid A. Fitz-James Antoine. Elevated ICP. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0023.

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Perioperative management of a patient with elevated intracranial pressure (ICP) is of paramount importance in neuroanesthesiology. Should this clinical emergency remain unaddressed, disability and death will ensue. Suboptimal care of a patient with elevated ICP is associated with avoidable morbidity and predictable mortality unless timely medical interventions, a focused history, targeted physical findings and a high degree of clinical suspicion confirmed by selective imaging result in medical stabilization and more definitive neurosurgical intervention. This may require interinstitutional tra

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42

Shimizu, Hideharu, Tomasz G. Rogula, and Philip R. Schauer. Safety and Efficacy of Bariatric Surgery in Patients with Cirrhosis. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0021.

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Perioperative risks for morbidly obese patients with cirrhosis are significant, and surgeons should consider these risks carefully in deciding on the type of bariatric procedure to be performed. The benefits of bariatric surgery for cirrhotic patients include substantial weight loss, improvements in metabolic diseases, and potential regression of fibrosis, which can also increase their eligibility and candidacy for liver transplantation. There is currently a lack of strong evidence, but the restrictive bariatric procedures are the safest options for carefully selected patients with cirrhosis.

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43

Hagerman, Nancy, and Eric Wittkugel. Preoperative Fasting in the Pediatric Patient. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0006.

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Preoperative fasting guidelines are designed to reduce the volume of gastric contents and to minimize the risk of pulmonary aspiration of gastric contents. Perioperative pulmonary aspiration in children is uncommon, with an incidence of between 1 and 10 per 10,000 anesthetics. It is associated with low morbidity and mortality. While fasting is important, it does not guarantee an empty stomach. Prolonged fasting in infants and children does not further reduce gastric volumes or increase safety but can be associated with unwanted effects such as irritability, parental dissatisfaction, hypoglycem

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44

Thompson, Jonathan P. Anaesthesia for vascular surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0058.

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Vascular surgical patients are at higher risk of cardiovascular morbidity and mortality than other surgical patients, and perioperative care remains challenging. However, vascular surgical practice is changing, with the expanding use of endovascular techniques to treat patients with vascular disease, improvements in medical therapy, and the evolution of evidence-based approaches to preoperative assessment. Preoperative assessment should concentrate on identifying and optimizing potentially correctable medical conditions, in particular cardiovascular disease. Successful outcomes depend on good

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Schwarte, Lothar A., Stephan A. Loer, J. K. Götz Wietasch, and Thomas W. L. Scheeren. Cardiovascular drugs in anaesthetic practice. Edited by Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0019.

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Anaesthetists should be familiar with currently available cardiovascular drugs used to maintain cardiovascular stability and achieve haemodynamic goals in surgical patients. The first part of this chapter summarizes antihypertensive agents, and the second part discusses positive inotropic drugs and vasopressors, which can be used perioperatively. Selection of vasoactive agents should be guided by the therapeutic goal (e.g. decreasing or increasing blood pressure or blood flow) and the underlying pathophysiology. Choice of catecholamines in a given situation should be based on the desired effec

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Books on the topic 'Perioperative mortality'

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