Perioperative Medicine Update

Excerpt

Evidence-based preoperative risk stratification and implementation of therapies to decrease morbidity and mortality are the focus of the preoperative evaluation that internists often perform in the office or the hospital setting. In this paper, we summarize some recent key advances in the field of perioperative medicine. We used a systematic search strategy to survey the relevant literature for the period January 1, 2007 through April 1, 2008. We performed a MEDLINE search using the medical subject heading (MeSH) terms intraoperative complications, postoperative complications, preoperative care, intraoperative care, perioperative care, postoperative care, intraoperative period, preoperative period, acute renal failure, cirrhosis, venous thromboembolism, and surgery. We added the following text words: intraoperative OR perioperative OR postoperative AND/OR complication OR event. As our target audience is general internists, we excluded studies of transplantation surgery, cardiac surgery, and pediatric surgery. We discuss studies that the four authors agreed had the most important practice implications for perioperative medicine. We have divided the articles into four sections: perioperative cardiac care, perioperative anticoagulant therapy, prevention of postoperative respiratory failure, and predicting postoperative risk of morbidity and mortality. …