Perioperative cardiovasular morbidity and mortality in noncardiac surgical interventions : Measures for optimal anesthesiological care.

[Perioperative cardiovasular morbidity and mortality in noncardiac surgical interventions : Measures for optimal anesthesiological care]. Anaesthesist. 2019 Jun 14;: Authors: Janßen H, Dehne S, Giannitsis E, Weigand MA, Larmann J Abstract Because of new surgical techniques, advanced monitoring modalities and improvements in perioperative care, perioperative mortality and morbidity have been significantly reduced in the last decades; however, patients still suffer from high perioperative mortality and morbidity, especially those with pre-existing cardiovascular diseases. Not only perioperative myocardial infarction but also myocardial injury after non-cardiac surgery, which presents without clinical symptoms, is associated with an adverse outcome. Patients at risk require particular interdisciplinary attention throughout the perioperative phase. The premedication visit is of particular importance. In addition to a thorough patient medical history and physical assessment, the perioperative handling of the patient's pre-existing medication and possible necessity for further preoperative tests should be verified. If necessary and where possible, optimization of the patient's state of health can be planned together with other disciplines. It is the anesthesiologist's responsibility to optimally guide and support patients with pre-existing cardiovascular diseases through the entire surgical procedure. This review summarizes perioperative interventio...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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Publication date: Available online 5 April 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Shaun McMahon, Rachael L. BirdAbstractPatients undergoing major vascular surgery are high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Endovascular procedures are less invasive, yet not devoid of potentially serious complications. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume re...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Publication date: July 2018Source: Anaesthesia &Intensive Care Medicine, Volume 19, Issue 7Author(s): Matthew Charlton, Jonathan P. ThompsonAbstractHeart failure (HF) and coronary insufficiency are common amongst surgical and critical care patients. Both are chronic conditions interrupted by acute episodes. HF activates neurohormonal mechanisms that worsen renal and cardiac function. Acute heart failure (AHF) commonly presents with dyspnoea as a consequence of systolic and/or diastolic dysfunction. Goals of treatment are symptom relief, to maintain tissue perfusion and optimize cardiac function. Diuretics and vasodilat...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
STATINS HAVE NUMEROUS intriguing and potentially desirable pleiotropic anti-inflammatory effects that may clinically benefit patients undergoing cardiac surgery with/without cardiopulmonary bypass.1,2 Suggested clinical benefits include decreased postoperative morbidity (renal dysfunction, atrial fibrillation, myocardial infarction, stroke, infection) as well as decreased in-hospital mortality. While suppressing perioperative inflammation in patients undergoing cardiac surgery appears to make sense, nothing is ever as simple as it seems.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
OVER THE past decade, the medical literature has reported conflicting opinions about resuming cardiovascular drug therapy during the postoperative period. Continuing oral cardiac medications after surgery is the general rule so as to preserve drug activity throughout the perioperative period. Clinical effects of stopping cardiac medication can include perioperative myocardial infarction (MI) and heart failure, which are leading causes of postoperative morbidity and mortality. However, it is alarming to learn that clinicians often fail to resume cardiovascular medical therapy, such as renin-angiotensin-aldosterone system (R...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research
Publication date: June 2016 Source:Best Practice & Research Clinical Anaesthesiology, Volume 30, Issue 2 Author(s): Hans-Joachim Priebe The perioperative period is associated with alterations in the neuroendocrine, metabolic, and immune systems, referred to as “stress response.” The resultant increased sympathetic activity and elevated serum concentrations of catecholamines may adversely affect the cardiovascular system, resulting in cardiovascular instability (hypertension, tachycardia, and arrhythmia), morbidity (myocardial ischemia, myocardial infarction, and stroke), and mortality (cardiac death and ...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
This study teaches us that poor wound healing and wrinkling and sagging that occur in aging skin share similar mechanisms." Reduced cell cohesiveness of outgrowths from eccrine sweat glands delays wound closure in elderly skin Human skin heals more slowly in aged vs. young adults, but the mechanism for this delay is unclear. In humans, eccrine sweat glands (ESGs) and hair follicles underlying wounds generate cohesive keratinocyte outgrowths that expand to form the new epidermis. Our results confirm that the outgrowth of cells from ESGs is a major feature of repair in young skin. Strikingly, in aged s...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Publication date: Available online 7 April 2016 Source:Best Practice & Research Clinical Anaesthesiology Author(s): Hans-Joachim Priebe The perioperative period is associated with alterations in the neuroendocrine, metabolic, and immune systems, referred to as 'stress response'. The resultant increased sympathetic activity and elevated serum concentrations of catecholamines may adversely affect the cardiovascular system resulting in cardiovascular instability (hypertension, tachycardia, arrhythmia), morbidity (myocardial ischemia, myocardial infarction, stroke) and mortality (cardiac death, fatal stroke), particular...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 11 March 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Rachael L. Bird, Ian Nesbitt Patients undergoing major vascular surgery are high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume resuscitation and effective analgesia. Continuation of preoperative risk reduction strategies includ...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 1 April 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): Takashi Kudo , Jonathan P. Thompson Heart failure (HF) and coronary insufficiency are common amongst surgical and critical care patients. Both are chronic conditions interrupted by acute episodes. HF activates neurohormonal mechanisms that worsen renal and cardiac function. Acute heart failure commonly presents with dyspnoea as a consequence of systolic and/or diastolic dysfunction. Goals of treatment are symptom relief, to maintain tissue perfusion and optimize cardiac function. Diuretics and vasodilators are used...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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