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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2018

01-06-2018 | Review

Perioperative myocardial injury and the contribution of hypotension

Authors: Daniel I. Sessler, Ashish K. Khanna

Published in: Intensive Care Medicine | Issue 6/2018

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Abstract

Mortality in the month following surgery is about 1000 times greater than anesthesia-related intraoperative mortality, and myocardial injury appears to be the leading cause. There is currently no known safe prophylaxis for postoperative myocardial injury, but there are strong associations among hypotension and myocardial injury, renal injury, and death. During surgery, the harm threshold is a mean arterial pressure of about 65 mmHg. In critical care units, the threshold appears to be considerably greater, perhaps 90 mmHg. The threshold triggering injury on surgical wards remains unclear but may be in between. Much of the association between hypotension and serious complications surely results from residual confounding, but sparse randomized data suggest that at least some harm can be prevented by intervening to limit hypotension. Reducing hypotension may therefore improve perioperative outcomes.
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Metadata
Title
Perioperative myocardial injury and the contribution of hypotension
Authors
Daniel I. Sessler
Ashish K. Khanna
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 6/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-5224-7

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