Surgery & Traumatology
Perioperative risk assessment & postoperative care
Perioperative risk assessment is crucial for reducing cardiovascular complications in non-cardiac surgery. Preoperative risk stratification, optimization of cardiovascular conditions, and intraoperative monitoring are essential. A multidisciplinary approach integrating tailored interventions and close monitoring improves patient outcomes.
Perioperative management of antithrombotic therapy involves balancing the risks of bleeding and thromboembolism. Individualized decision-making, considering patient-specific risks and surgical factors, is essential for optimizing antithrombotic management. Strategies include interrupting and resuming anticoagulants and antiplatelets, with bridging therapy for high-risk patients.
Postoperative care for cardiac surgical patients requires vigilant monitoring and early intervention to address complications. Hemodynamic management, prevention of bleeding, and treatment of arrhythmias are crucial in the early postoperative phase. Long-term recovery focuses on managing renal dysfunction, preventing infections, and providing nutritional support and rehabilitation. A comprehensive approach, including psychological care and follow-up, supports improved outcomes and quality of life.
Perioperative risk assessment
Cardiovascular risk assessment
2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery: Developed by the task force for cardiovascular assessment and management of patients undergoing non-cardiac surgery of the European Society of Cardiology (ESC)
Sigrun Halvorsen et al., European Heart Journal (2022)
What’s inside
The 2022 ESC guidelines provide evidence-based recommendations for the cardiovascular assessment and management of patients undergoing non-cardiac surgery, aiming to reduce perioperative risks.
Why it’s relevant
Cardiovascular complications are a major cause of morbidity and mortality in non-cardiac surgery, making preoperative assessment and management critical.
Key focus
- Preoperative risk stratification using clinical scores and biomarkers
- Optimization of cardiovascular conditions before surgery
- Intraoperative monitoring and hemodynamic management
- Postoperative care and long-term follow-up strategies
Takeaway
The guidelines emphasize a multidisciplinary approach to perioperative care, integrating risk assessment, tailored interventions, and close monitoring to improve outcomes in patients undergoing non-cardiac surgery.
Perioperative management of antithrombotic therapy
Perioperative management of antithrombotic therapy
Perioperative Management of Antithrombotic Therapy
James D. Douketis et al., Chest (2022)
What’s inside
This article provides updated guidelines for the perioperative management of antithrombotic therapy, focusing on balancing the risks of bleeding and thromboembolism in surgical patients.
Why it’s relevant
Perioperative management of antithrombotic therapy is critical to prevent both bleeding complications and thromboembolic events during and after surgery.
Key focus
- Risk assessment for bleeding and thromboembolism
- Perioperative interruption and resumption of anticoagulants and antiplatelets
- Bridging therapy for high-risk patients on vitamin K antagonists
- Special considerations for direct oral anticoagulants (DOACs)
Takeaway
The guidelines emphasize individualized decision-making, integrating patient-specific risks and surgical factors to optimize perioperative antithrombotic management and improve outcomes.
Postoperative care
Postoperative care
Postoperative Critical Care of the Adult Cardiac Surgical Patient, Part I
R. Scott Stephens et al., Critical Care Medicine (2015)
What’s inside
This article, Part I of a two-part series, reviews the postoperative critical care management of adult cardiac surgical patients, focusing on early postoperative complications and interventions.
Why it’s relevant
Cardiac surgery patients are at high risk for postoperative complications, requiring specialized critical care to optimize recovery and outcomes.
Key focus
- Hemodynamic monitoring and management
- Prevention and treatment of postoperative bleeding
- Management of arrhythmias and low cardiac output syndrome
- Strategies for mechanical ventilation and early extubation
Takeaway
The article highlights the importance of vigilant monitoring, early intervention, and tailored management to address complications and improve outcomes in cardiac surgical patients.
Postoperative care
Postoperative Critical Care of the Adult Cardiac Surgical Patient, Part II
R. Scott Stephens et al., Critical Care Medicine (2015)
What’s inside
This article, Part II of a two-part series, focuses on the later stages of postoperative critical care for adult cardiac surgical patients, addressing complications and long-term recovery.
Why it’s relevant
Long-term recovery and management of complications are crucial for improving outcomes and quality of life in cardiac surgical patients.
Key focus
- Management of renal dysfunction and acute kidney injury
- Strategies for infection prevention and treatment
- Nutritional support and rehabilitation
- Psychological care and long-term follow-up
Takeaway
The article emphasizes a comprehensive approach to postoperative care, integrating multidisciplinary interventions to address complications and support recovery in cardiac surgical patients.