Primary systemic hypertension affects 10%-25% of individuals presenting for surgery and anaesthesia and constitutes an important cause of cancellation of elective surgeries. Much of the fear stems from the fact that hypertension may lead to adverse perioperative outcomes. Although long-standing hypertension increases the risk of stroke, renal dysfunction or major adverse cardiovascular events, ...

Perioperative myocardial infarction is a major cause of complications and death among patients undergoing noncardiac surgery. 1 Annually in the United States, approximately 27 million patients are given anesthesia for surgical procedures; of these, approximately 50,000 patients have a perioperative myocardial infarction. 2 The pathophysiology of an acute perioperative myocardial infarction is p...

Near-infrared spectroscopy (NIRS) is used to monitor regional cerebral oxygenation (rScO2) during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed (i) to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and (ii) to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and ...

Anaesthesia and surgery induce major changes in respiratory function, in particular when the thorax or the upper abdomen are involved. Pulmonary volumes decrease, and atelectasis can develop. Postoperative pain and diaphragm dysfunction further worsen the respiratory function, contributing to the risk of acute respiratory failure. non-invasive ventilation proved to be beneficial in the postoper...

BackgroundValvular heart disease is one of the common complications of acute rheumatic fever, which manifests its clinical complications one or two decades after the primary attack of the disease in adults. The disease may involve one or more valves as stenosis or regurgitation or both and may cause congestive heart failure due to chronic volume or pressure overload. MethodThis prospective stud...

Although the efficacy of extracorporeal circulation (ECC) is well established for open-heart surgery, application of ECC in other surgical areas has not been given much attention. Advances in the related surgical technique and anesthetic management combined with refinements in the ECC procedure itself have encouraged several institutions to use ECC for complex non-cardiac surgeries. ECC is begi...

Over 10 million major non-cardiac surgical procedures were performed in the U.S. in 2000 There have been significant advances in the care of the perioperative patient undergoing non-cardiac surgery in the last two decades. These have primarily been aimed at the assessment and risk modification of those patients with coronary artery disease. Patients with heart failure (HF), however, represent a...

IMPORTANCE Regular oral care with chlorhexidine gluconate is standard of care for patients receiving mechanical ventilation in most hospitals. This policy is predicated on meta-analyses suggesting decreased risk of ventilator-associated pneumonia, but these meta-analyses may be misleading because of lack of distinction between cardiac surgery and non-cardiac surgery studies, conflation of open-...

Cardiac risk factors were studied among patients who were admitted to hospital with appendicitis or a fracture of the proximal femur less than one year after being admitted with myocardial infarction. Of 99 patients with myocardial infarction and appendicitis, 87 underwent appendicectomy; and of 221 with myocardial infarction and hip fracture, 179 were operated on. The patients were studied on ...