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6.1 - Management of Pre- and Post-operative Care of the High-Risk Surgical Patient

from Section 6 - Perioperative Care

Published online by Cambridge University Press:  27 July 2023

By
John Whittle
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. High-risk surgery is associated with significant inpatient mortality, and post-operative morbidity is associated with increases in long-term morbidity and mortality.

  2. 2. Perioperative care should be a team effort and proactive, rather than reactive.

  3. 3. Adequate risk assessment and ICU care triage are key to effective perioperative care.

  4. 4. Care bundles may reduce risk across a variety of surgeries and medical conditions through the aggregation of marginal gains.

  5. 5. Clear handover in the ICU can reduce medical error and improve patient safety.

Keywords

risktriageperioperativeoptimisationcritical care
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 623 - 626
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Fleisher, LA, Fleischmann, KE, Auerbach, AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation 2014;130:e278–333.Google Scholar
Pearse, RM, Holt, PJE, Grocott, MPW. Managing perioperative risk in patients undergoing elective non-cardiac surgery. BMJ 2011;343:d5759.CrossRefGoogle ScholarPubMed
Pearse, RM, Moreno, RP, Bauer, P, et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet 2012;380:1059–65.CrossRefGoogle ScholarPubMed
Sobol, JB, Wunsch, H. Triage of high-risk surgical patients for intensive care. Crit Care 2011;15:217.CrossRefGoogle ScholarPubMed
The Royal College of Anaesthetists. 2015. Perioperative medicine: the pathway to better surgical care. www.rcoa.ac.uk/sites/default/files/documents/2019-08/Perioperative%20Medicine%20-%20The%20Pathway%20to%20Better%20Care.pdfGoogle Scholar

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