PERI OPERATIVE MANAGEMENT OF THE HIGH RISK SURGICAL PATIENT

Abstract

K. P. S. Bhushan1, K. S. Narasimha Murthy2

ABSTRACT: Around 15% of people who undergo inpatient surgery are at high risk of complications, such as pneumonia or myocardial infarction, Because of age, comorbid disease, or the complexity of the surgical procedure. Identification of high risk patients pre-operatively based on patient and/or surgical criteria or by formal dynamic testing of functional capacity is desirable and possible. An increase in the availability of less invasive monitoring equipment, including oesophageal Doppler and arterial waveform analysis, has facilitated the widespread use of cardiac output monitoring. Starting goal directed therapy at any time during the peri-operative period has shown benefit. More effective systems can improve quality of perioperative care and may improve survival while reducing healthcare costs.
 

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