Perioperative Care: Physiology and Practicality
Anaesthesiologists and critical care practitioners are increasingly responsible not only for satisfactory clinical outcomes following surgery, but also for insuring appropriate utilization of the resources involved. Indeed, clinical pathways have provided a powerful tool to track patients’ progress, and early intervention stimulated by physiological deviation from the expected course may prove beneficial and decrease total length of hospital stay despite the possibility of increasing time in the ICU. To accommodate these responsibilities, physicians must hone traditional clinical skills while learning the new behaviors associated with integrating business practices into medical care. Certainly, the art as well as the science of medicine are still alive, but the understanding of medicine as a business is a reality that clinicians ignore at their peril. The following discussion will focus on two traditional areas of perioperative care. It will conclude by introducing a third arena in which physician interest and direction will dictate future success.
KeywordsCardiac Output Critical Care Total Quality Management Oxygen Extraction Ratio Venous Oxygen Content
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- 1.Civetta JM (1998) Bedside use of arterial and venous oximetry. In: Monitoring: Practical applications, pp 313–324Google Scholar
- 2.Sutter PM, Fairley B, Schlobohm D (1975) Shunt, lung volume and perfusion during short periods of ventilation with oxygen. Anesthesiology 43Google Scholar
- 4.Nelson LD (1983) Continuous venous oximetry in surgical patients. Ann Surg 203:349–352Google Scholar
- 7.Gould SA, Rice CL, Moss GS (1984) The physiologic basis of the use of blood and blood products. Surg Annual 16:13Google Scholar