Valvular Heart Disease
CHAPTER 13 Valvular Heart Disease Kenneth Ong, MD Valvular heart disease affects 2.5% of the population in the United States with an equal gender distribution, but is found more…
Perioperative Supplemental Oxygen to Reduce Perioperative Mortality
Fig. 10.1 The “oxygen cascade” with partial pressure of oxygen (PO 2 ) falling from ambient air to the mitochondria. Factors affecting oxygenation at different levels are shown at the top…
Chlorhexidine Oral Rinse to Reduce Perioperative Mortality
Fig. 12.1 Structure of chlorhexidine (1:6-di[4-chlorophenyldiguanido]-hexane). The two biguanide groups (green arrows) are protonated at physiological pH (as shown in the yellow box) so that the molecule is positively charged Chlorhexidine…
Role of Perioperative Hemodynamic Optimization in Reducing Perioperative Mortality
Authors, Year, Type of study Studies, Number of participants Type of patients Monitoring devices Conclusions Poeze et al. [9], Meta-analysis 30 RCTs, 5,733 pts High-risk surgery, trauma, acute medical sepsis…
Aprotinin: Pharmacological Benefits and Safety Concerns
Meta-analysis Year of publication Number of patients Number of studies OR (CI 95 %) OR (CI 95 %) OR (CI 95 %) – – – – Aprotinin versus tranexamic acid Aprotinin versus aminocaproic…
Consensus Conference on Perioperative Mortality: An Update
Search strategy for meta-analyses of RCTs Systematic [sb.] AND (surgery [tiab] OR surgical* [tiab] OR operation* [tiab]) AND [(myocardial AND infarction) OR (death* OR survival OR mortality OR prognosis)] AND…
Role of Insulin in Reducing Mortality in the Perioperative Period
Route of administration Insulin Onset of action Peak of action Effective duration of action Subcutaneous Regular human insulin 30–60 min 2–3 h 4–6 h Subcutaneous Rapid-acting analogues (aspart, lispro, glulisine) 15 min 30–90 min 3–4 h…
Selective Decontamination of the Digestive Tract
Target PPM, antimicrobials, manoeuvres Total daily dosea <5 years 5–12 years >12 years Parenteral antimicrobials – – – Cefotaxime, mg 150/kg 200/kg 4,000 Enteral antimicrobials – – – Oropharynx – – – AGNB:…
Reducing Perioperative Mortality with Intra-Aortic Balloon Counterpulsation (IABP)
Clinical summary Indications Cautions Complications Notes High-risk coronary artery bypass grafting Aortic regurgitation Aggravation of aortic regurgitation Imaging is required to confirm correct aortic placement of this device Severe myocardial…
The Process of Consensus Building
Fig. 2.1 Consensus conference process 2.1 Step 1. Evidence Collection and Analysis The aim of this conference was to identify all the interventions influencing mortality in the perioperative period, including only…
