Evidence-based perioperative risk reduction

Perioperative cardiac risk reduction.

Cardiovascular complications are the most common cause of perioperative morbidity and mortality. Noninvasive stress testing is rarely helpful in assessing risk, and for most patients there is no evidence that coronary revascularization provides more protection against perioperative cardiovascular events than optimal medical management. Patients likely to benefit from perioperative beta blockade...

Perioperative cardiac risk reduction: doing it right.

Perioperative glycemic control: an evidence-based review.

Hyperglycemia in perioperative patients has been identified as a risk factor for morbidity and mortality. Intensive insulin therapy (IIT) has been shown to reduce morbidity and mortality among the critically ill, decrease infection rates and improve survival after cardiac surgery, and improve outcomes in acute neurologic injury and acute myocardial infarction. However, recent evidence of severe...

Perioperative cardiac evaluation: assessment, risk reduction, and complication management.

Perioperative cardiac complications are among the most feared outcomes after surgery. Using evidence-based guidelines and expert opinion, physicians can perform a risk assessment and decide whether further cardiac testing, medical therapy, or coronary intervention is necessary to optimize the patient's medical condition prior to surgery. This article reviews the major concepts and recommendatio...

Clinical review: Evidence-based perioperative medicine?

The present article outlines the basic principles of Evidence Based Medicine (EBM) and how they should guide clinical practice. The evidence supporting a selection of perioperative interventions is assessed against objective criteria. Many of the perioperative interventions that have been widely adopted into clinical practice are supported by very limited evidence. Conversely a high level of ev...