Perioperative care
Perioperative care is defined as "interventions to provide care prior to, during, and immediately after surgery."[1]
Classification
Intraoperative Care
Postoperative Care
Components of postoperative care may include incentive spirometry.
Benefits of perioperative medical consultation
The benefits of consultation are not clear in an observational study.[2]
Specific interventions
Blood transfusions
Among patients receiving coronary artery bypass grafting, there may be no meaningful difference between transfusing to maintain a hemoglobin levels > 8 g/dL versus a hemoglobin levels > 9 g/dL.[3] However, hemoglobin levels < 8 g/dL may increase complications.[4]
Glucose control
Regarding intraoperative control of glucose, a randomized controlled trial concluded "the increased incidence of death and stroke in the intensive treatment group raises concern about routine implementation of this intervention."[5]
References
- ↑ National Library of Medicine. Perioperative care. Retrieved on 2007-11-21.
- ↑ Auerbach AD, Rasic MA, Sehgal N, Ide B, Stone B, Maselli J (2007). "Opportunity missed: medical consultation, resource use, and quality of care of patients undergoing major surgery". Arch. Intern. Med. 167 (21): 2338–44. DOI:10.1001/archinte.167.21.2338. PMID 18039993. Research Blogging.
- ↑ Bracey AW, Radovancevic R, Riggs SA, et al (1999). "Lowering the hemoglobin threshold for transfusion in coronary artery bypass procedures: effect on patient outcome". Transfusion 39 (10): 1070–7. PMID 10532600. [e]
- ↑ Carson JL, Noveck H, Berlin JA, Gould SA (2002). "Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion". Transfusion 42 (7): 812–8. PMID 12375651. [e]
- ↑ Gandhi GY, Nuttall GA, Abel MD, et al (2007). "Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial". Ann. Intern. Med. 146 (4): 233–43. PMID 17310047. [e]