Journals / Türk Anestezi ve Reanimasyon Dergisi / 2013 / Cilt: 41 - Sayı: 6

Can we ımprove outcome in high risk surgery?

Yüksek riskli cerrahide sonucu iyileştirebilir miyiz?

Pages
191–194
Publication Date
2022-11-05
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Despite the small number of high-risk surgical patients in comparison to all surgical patients, they account for the largest proportion of overall pe- rioperative mortality.

📌 3 Key Takeaways

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Objective & Hypothesis:Despite the small number of high-risk surgical patients in comparison to all surgical patients, they account for the largest proportion of overall pe- rioperative mortality.
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Key Findings & Data:Beyond the standard monitoring of circulation, such as blood pressure and heart rate, further parameters and procedures such as pulse pressure/stroke volume variation-, stroke volume/cardiac index-, and central venous oxygen saturation-guided resuscitation may improve the outcome of high-risk surgical patients.
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Conclusion & Impact:The aim of this review is to focus on the results of animal and clinical studies investigating the usefulness of these indices in the context of goal-directed perioperative support.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Despite the small number of high-risk surgical patients in comparison to all surgical patients, they account for the largest proportion of overall pe- rioperative mortality. Goal directed hemodynamic support may result in a lower incidence of complications and reduced length of hospital stay in these patients. Beyond the standard monitoring of circulation, such as blood pressure and heart rate, further parameters and procedures such as pulse pressure/stroke volume variation-, stroke volume/cardiac index-, and central venous oxygen saturation-guided resuscitation may improve the outcome of high-risk surgical patients. The aim of this review is to focus on the results of animal and clinical studies investigating the usefulness of these indices in the context of goal-directed perioperative support.

Özet

Yüksek riskli cerrahi hastaları tüm cerrahi hastalarına kıyasla az sayıda olmalarına rağmen, tüm perioperatif mortalitenin en büyük kısmından sorumludurlar. Bu hastalarda hedefe yönelik hemodinamik destek daha düşük bir komplikasyon insidansına ve hastanede yatış süresinde azalma- ya neden olabilir. Kan basıncı ve kalp hızı gibi dolaşımın standart takibi ötesinde nabız basıncı/atım hacmi varyasyonu-, atım hacmi/kalp indeksi ve santral venöz oksijen satürasyonu-güdümlü resüsitasyon gibi daha ileri parametreler ve uygulamalar yüksek riskli cerrahi hastalarda sonucu iyileş- tirebilir. Bu derlemenin amacı hedefe yönelik perioperatif destek bağla- mında bu endekslerin yararlılığını araştıran hayvan çalışmalarının ve klinik çalışmaların sonuçlarına odaklanmaktır.

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Cite This Article

MİKOR, A., MOLNAR, Z. (2022). Can we ımprove outcome in high risk surgery?. Türk Anestezi ve Reanimasyon Dergisi, Cilt: 41 - Sayı: 6, 191–194. https://ajindex.com/articles/619752

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References (2)

  1. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling stra- tegy based on available data. Lancet 2008; 372: 139-44. [CrossRef] Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical pati- ents in Australia. Int J Qual Health Care 2002; 14: 269-76. [CrossRef] Gawande AA, Thomas EJ, Zinner MJ, Brennan TA. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Sur- gery 1999; 126: 66-75. [CrossRef ] Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet 2012; 380: 1059-65. [CrossRef ] Khuri SF, Daley J, Henderson W, Hur K, Gibbs JO, Barbour G, et al. Risk adjustment of the postoperative mortality rate for the comparative assess- ment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg 1997; 185: 315-27. [CrossRef] Daley J, Khuri SF, Henderson W, Hur K, Gibbs JO, Barbour G, et al. Risk adjustment of the postoperative morbidity rate for the comparative assess- ment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am Coll Surg 1997; 185: 328-40. [CrossRef] Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ; Participants in the VA National Surgical Quality Imp- rovement Program. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005; 242: 326-43.
  2. Mythen MG, Webb AR. Intraoperative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Inten- sive Care Med 1994; 20: 99-104. [CrossRef ] Shoemaker WC, Wo CC, Thangathurai D, Velmahos G, Belzberg H, Asensio JA, et al. Hemodynamic patterns of survivors and nonsurvivors during high risk elective surgical operations. World J Surg 1999; 23: 1264-71. [CrossRef ] Sinclair S, James S, Singer M. Intraoperative intravascular volume opti- misation and length of hospital stay after repair of proximal femoral frac- ture: randomised controlled trial. BMJ 1997; 315: 909-12. [CrossRef] Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth 2002; 89: 622-32. [CrossRef] Lowell JA, Schifferdecker C, Driscoll DF, Benotti PN, Bistrian BR. Postoperative fluid overload: not a benign problem. Crit Care Med 1990; 18: 728-33. [CrossRef ] Joshi GP. Intraoperative