Ventricular Arrhythmias in Patients Undergoing Noncardiac Surgery

O’Kelly, Brian

doi:10.1001/jama.1992.03490020065032

Cited by 94 publications

(7 citation statements)

References 30 publications

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“…El tabaco afecta la oferta y el consumo de oxígeno al miocardio durante el perioperatorio, debido al aumento de la resistencia vascular coronaria (vasoconstricción y aumento de la agregación plaquetaria) y de los niveles elevados de carboxihemoglobina 35 . Algunos investigadores demostraron una asociación entre tabaquismo y complicaciones cardiacas postoperatorias, pero siempre sin mucha consistencia 36,37 .…”

Section: Discussionunclassified

Associação independente do tabagismo aos eventos cardíacos pós-operatórios e à mortalidade em 30 dias

Sakuma

Machado

Martins

2010

Arq. Bras. Cardiol.

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Section: Discussionunclassified

Associação independente do tabagismo aos eventos cardíacos pós-operatórios e à mortalidade em 30 dias

Sakuma

Machado

Martins

2010

Arq. Bras. Cardiol.

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“…Ventricular arrhythmias on preoperative ECG monitoring did not portend the development of worse arrhythmias during and after surgery. Although 44% of the patients had ventricular arrhythmias at some time during perioperative monitoring, sustained ventricular tachycardia or ventricular fibrillation did not occur [43].…”

Section: Specific Risk Indicesmentioning

confidence: 94%

Perioperative Risk Stratification in Patients Undergoing Noncardiac Surgery

Kloehn¹,

O’Rourke²

1999

J Intensive Care Med

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Adverse cardiac events during noncardiac surgery are a major cause of morbidity and mortality. As the population ages, greater numbers of patients (including the elderly) are undergoing noncardiac surgical procedures; additional emphasis must therefore be placed on effective preoperative risk assessment. On a national level, the estimated annual expenditure for this process is already $3.7 billion. There is a need for both the specialist and primary care provider to execute a safe, methodical, and cost efficient screening plan. This process should identify both the patients at highest risk and also those at lowest risk. Subsequently, the emphasis should attempt to minimize the overall risk of perioperative complications. The cornerstone of risk assessment requires meticulous history taking, a thorough physical examination, and usually a chest radiograph and an ECG. Five subsequent (basic) steps for the evaluation of patients for noncardiac surgery are outlined here in assessment of clinical markers and the pa- tient's functional capacity, risk of the surgical procedure, the need for noninvasive testing, and when appropriate, the indications for invasive testing. The AHA/ACC Practice Guidelines Committee has outlined a clinical algorithm which provides a stepwise approach to guide the clinician during the decision making process. The purpose of preoperative evaluation is not to "give medical clearance" per se, but rather to evaluate the patient's current medical status, detect stress-induced ischemia in a cost effective manner, and to make recommendations about patient management throughout the entire perioperative period.

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“…Later on, diagrams and tables for risk assessment of ischemic complications [19,41,43], lifethreatening ischemic complications [17,36,44,45], tachyarrhythmias [24], and ventricular arrhythmias [49] were proposed. The scales and the statements about the probability of ischemic complications comprise of several symptoms, derived from clinical, laboratory, imaging, and electrophysiological examinations.…”

Section: Non-point Scales For Cardiac Risk Assessmentmentioning

confidence: 99%