Abstract
Elderly patients have more comorbidities and are increasingly undergoing more complex procedures. Despite the ever aging population, expected mortality continues to decline. This is based in part on our increased understanding of the complex physiology of the elderly and improved medications and monitoring techniques now in use to mitigate adverse outcomes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Keefover RW. Aging and cognition. Neurol Clin. 1998;16(3):635–48.
Pandharipande P, Cotton BA, Shintani A, Thompson J, Pun BT, Morris Jr JA, et al. Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma. 2008;65(1):34–41.
Larsen SF, Zaric D, Boysen G. Postoperative cerebrovascular accidents in general surgery. Acta Anaesthesiol Scand. 1988;32(8):698–701.
Parikh S, Cohen JR. Perioperative stroke after general surgical procedures. NY State J Med. 1993;93(3):211–5.
Kim J, Gelb AW. Predicting periopeative stroke. J Neurosurg Anesthesiol. 1995;7(3):211–5.
Kam PC, Calcroft RM. Peri-operative stroke in general surgical patients. Anesthesia. 1997;52(9):879–83.
Limburg M, Wijdicks EF. LiH. Ischemic stroke after surgical procedures: clinical features, neuroimaging, and risk factors. Neurology. 1998;50(4):895–901.
Landercasper J, Merz BJ, Cogbill TH, et al. Perioperative stroke risk in 173 consecutive patients with a past history of stroke. Arch Surg. 1990;125:986–9.
Zile MR, Brustsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: part II: Causal mechanisms and treatment. Circulation. 2002;105:1503.
Vasan R, Larson M, Benjamin E, et al. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. J Am Coll Cardiol. 1999;33:1948–55.
Ebert TJ, Rooke GA. Alterations in circulatory function. In: Silverstein JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer; 2008. p. 137–48.
Groban L, Dolinski SY. Transesophageal echocardiographic evaluation of diastolic function. Chest. 2005;128(5):3652–63.
Vinch CS, Aurigemma GP, Simon HU, et al. Analysis of left ventricular systolic function using midwall mechanics in patients >60 years of age with hypertensive heart disease and heart failure. Am J Cardiol. 2005;19:59–64.
Turner MJ, Cm M, Spina RJ, et al. Effects of age and gender on cardiovascular responses to phenylephrine. J Gerontol Med Sci. 1999;54A:M17–24.
Brodde O-E, Leineweber K. Autonomic receptor systems in the failing and aging human heart: similarities and differences. Eur J Pharmacol. 2004;500:167–76.
Carti-Ceba R, Spring J, Gajic O, Warner D. The aging respiratory system: anesthetic strategies to minimize perioperative pulmonary complications. In: Silverstein JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer; 2008. p. 149–64.
McEvoy MD, Reves JG. Intravenous hypnotic anesthetics. In: Silverstien JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer; 2008. p. 229–45.
Epstein M. Aging and the kidney. J Am Soc Nephrol. 1996;7:1106–22.
Cogliati AA, Vellutini R, Nardini A, Urovi S, Hamdan M, Landoni G, et al. Fenoldopam infusion for renal protection in high-risk cardiac surgery patients: a randomized clinical study. J Cardiothorac Vasc Anesth. 2009;23(1):128.
Jack Jr L, Boseman L, Vinicor F. Aging Americans and diabetes. A public health and clinical response. Geriatrics. 2004;59:14–7.
King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21:1414–31.
Finfer S, Chittock DR, et al. Intesnsive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283–97.
Phillips PA, Rolls BY, Ledingham JG, Forsling ML, Morton JJ, Crowe MJ. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med. 1984;311:753–9.
Weidmann P, Demyttenaere-Bursztein S, Maxwell MH, DeLima J. Effect of againg on plasma rennin and aldosterone in normal man. Kidney Int. 1975;8:325–33.
Robin ED. Defenders of the pulmonary artery catheter. Chest. 1988;93:1059.
Dalen JE, Bone RC. Is it time to pull the pulmonary artery catheter? JAMA. 1996;276:916.
Roberts KW, Crnkowic AP, Linneman LJ. Near-infrared spectroscopy detects critical cerebral hypoxia during carotid endarterectomy in awake patients. Anesthesiology. 1998;89(3A):A934.
Cho H, Nemoto E, Yonas H. Cerebral monitoring by means of oximetry and somatosensory evoked potential during carotid endarterectomy. J Neurosurg. 1998;89:533.
Monk TG, Reno KA, Olsen BS, et al. Postoperative cognitive dysfunction is associated with cerebral oxygen desaturations. Anesthesiology. 2000;93:A167.
Vohra HA, Modi A, Ohri SK. Does use of intra-operative cerebral regional oxygen saturation monitoring during cardiac surgery lead to improved clinical outcomes? Interact Cardiovasc Thorac Surg. 2009;9(2):318–22.
Myles PS, Leslie K, McNeil J, et al. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomized controlled trial. Lancet. 2004;363:1757.
Kahn RA, Shernan SK, Konstadt SN. Intraoperative echocardiography. In: Kaplan JA, Reich DL, Lake CL, Konstadt SN, editors. Kaplan’s cardiac anesthesia. 5th ed. Philadelphia: Saunders Elsevier; 2006. p. 437–88.
Thys DM, et al. Practice guidelines for perioperative transesophageal echocardiography. Anesthesiology 2010;112(1).
Eltzschig HK, Rosenberger P, Loffler M, Fox JA, Aranki SF, Shernan SK. Impact of intraoperative transesophageal echocardiography on surgical decisions in 12, 566 patients undergoing cardiac surgery. Ann Thorac Surg. 2008;85(3):845–52.
Hartman GS, Yao FS, Bruefach 3rd M, et al. Severity of aortic atheromatous disease diagnosed by transesophageal echocardiography predicts stroke and other outcomes associated with coronary artery surgery: a prospective study. Anesth Analg. 1996;83:701.
Katz ES, Tunick PA, Rusinek H, et al. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophagela echocardiography. J Am Coll Cardiol. 1992;20:70.
Rosenberger P, Shernan SK, Loffler M, Shekar PS, Tuli FJA, JK NM, et al. The influence of epiaortic ultrasonography on intraoperative surgical management in 6051 cardiac surgical patients. Ann Thorac Surg. 2008;85(2):548–53.
Tuman KJ, McCarthy RJ, Spiess BD, Ivankovich AD. Comparison of anesthetic techniques in patients undergoing heart valve replacement. J Cardiothorac Anesth. 1990;4(2):159–67.
Tuman KJ, McCarthy RJ, Spiess BD, DaValle M, Dabir R, Ivankovich AD. Does choice of anesthetic agent significantly affect outcome after coronary artery surgery? Anesthesiology. 1989;70(2):189–98.
Schnider TW, Minto CF, Gumbus PL, et al. The influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteers. Anesthesiology. 1998;88(5):1170–82.
Ball C, Westhorpe R. The history of intravenous anaesthesia: the barbiturates. Part 1. Anaesth Intensive Care. 2001;19(2):97.
Ball C, Westhorpe R. The history of intravenous anaesthesia: the barbiturates. Part 2. Anaesth Intensive Care. 2001;29(3):219.
Ball C, Westhorpe R. The history of intravenous anaesthesia: the barbiturates. Part 3. Anaesth Intesive Care. 2001;29(4):323.
Vinclair M, Broux C, Faure P, Brun J, Genty C, Jaquot C, et al. Duration of adrenal inhibition following a single dose of etomidate in critically ill patients. Intesive Care Med. 2008;34(4):714–9.
Reves JG, Fragen RJ, Vinik HR, et al. Midazolam: pharmacology and uses. Anesthesiology. 1985;62:310.
Harper KW, Collier PS, Dundee JW, et al. Age and nature of operation influence the pharmacokinetics of midazolam. Br J Anesth. 1985;57:866.
Ishikawa S, Kugawa S, Neya K, Suzuki Y, Kawasaki A, Hayama T, et al. Hemodynamic effects of dexmedetomidine in patients after cardiac surgery. Minerva Chir. 2006;61(3):215–9.
Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50(3):206–17.
Stanley TH, Webster LR. Anesthetic requirements and cardiovascular effects of fentayl-oxygen and fentanyl-diazempam-oxygen anesthesia in man. Anesth Analg. 1978;57:411.
Murphy GS, Szokol JW, Marymont JH, et al. Morphine-based cardiac anesthesia provides superior early recovery compared with fentanyl in elective cardiac surgery patients. Anesth Analg. 2009;109(2):311–9.
Ouattara A, Lecomte P, LeManach Y, et al. Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology. 2005;103:4.
Egi M, Bellomo R, Stachowski E, et al. Variability of blood glucose concentration and short-term mortality in critically ill patients. Anesthesiology. 2006;105:2.
van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the surgical intensive care unit. N Engl J Med. 2001;345:1359.
Nauphal M, El-Khatib M, Taha S, Haroun-bizri S, Alameddine M, Baraka A. Effect of alpha-stat vs. pH-stat strategies on cerebral oximetry during moderate hypothermic cardiopulmonary bypass. Eur J Anaesthesiol. 2007;24(1):15–9.
Patel RL, Turtle MR, Chambers DJ, et al. Alpha-stat acid-base regulation during cardiopulmonary bypass improves neuropsychologic outcome in patients undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1996;111:1267.
Landoni G, Fochi O, Tritapep L, Garracino F, Belloni I, Bignami E, et al. Cardiac protection by volatile anesthetics. A review. Minerva Anestesiol. 2009;75(5):269–73.
Culley DJ, Monk TG, Crosby G. Postoperative central nervous system dysfuncion. In: Silverstein JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer; 2008. p. 123–36.
Abernathy JH. Cardiac procedures. In: Silverstien JH, Rooke GA, Reves JG, McLeskey CH, editors. Geriatric anesthesiology. 2nd ed. New York: Springer; 2008. p. 229–45.
Reves JH, Reeves S, Abernathy JH, editors. Atlas of cardiothoracic anesthesia. 2nd ed. New York: Current Medicine Group, Springer; 2009.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Nelson, E.W., Abernathy, J.H. (2011). Cardiac Anesthesia in the Elderly. In: Katlic, M. (eds) Cardiothoracic Surgery in the Elderly. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0892-6_28
Download citation
DOI: https://doi.org/10.1007/978-1-4419-0892-6_28
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-0891-9
Online ISBN: 978-1-4419-0892-6
eBook Packages: MedicineMedicine (R0)