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Controversial Aspects in Perioperative Medicine

  • G. Galimberti
Conference paper

Abstract

Recently, current financial constraints across the medical sector, accompanied by increasing litigation by patients and/or relatives, has resulted in a renewed interest in the link between anesthesia and surgical outcome. Epidemiological studies have shown that cardiovascular disease continues as the leading cause for death in developed and in non-developed countries [1]. It is calculated that in year 2001 approximately 100 million patients will undergo surgery throughout the world, with one-third being more than 65 years of age or having two or more cardiovascular risk factors. Among these patients, 10% will suffer a perioperative myocardial ischemia causing a 50% reduction in their 2-year survival rate, and increasing world health care costs by an additional 50 billion dollars [2]. Although cardiovascular complications after surgery are well recognized, a great deal remains unknown and a number of controversies persist, not the least of which is the appropriate methodology for detection of perioperative morbidity and costly outcome. Furthermore, it is increasing the pressure on physicians of all specialties who have to account for their actions and supply supported reasoning for their actions. Evidence-based medicine, that is the approach to clinical practice based on knowledge of the evidence supported by literature appraisal and application, has been promoted as tool to provide physicians with the necessary means to evaluate the current basis for any proposed intervention.

Keywords

Pulmonary Capillary Wedge Pressure Anesthetic Technique Noncardiac Surgery Controversial Aspect Ventricular Stroke Work Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2002

Authors and Affiliations

  • G. Galimberti
    • 1
  1. 1.Department of Clinical Sciences, Section of AnaesthesiaIntensive Care and Pain Clinic, Trieste University School of MedicineTriesteItaly

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