Abstract
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.
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References
Civetta JM (1998) Bedside use of arterial and venous oximetry. In: Monitoring: Practical applications, pp 313–324
Sutter PM, Fairley B, Schlobohm D (1975) Shunt, lung volume and perfusion during short periods of ventilation with oxygen. Anesthesiology 43
Bongard FS, Leighton TA (1992) Continuous dual oximetry in surgical critical care: Indications and limitations. Ann Surg 216(1):60–68
Nelson LD (1983) Continuous venous oximetry in surgical patients. Ann Surg 203:349–352
Mitchell LA, Downs JB, Dannemiller FJ (1975) Extrapulmonary influences on (A-a) DO2 following cardiopulmonary bypass. Anesthesiology 43:583–586
Rasanen J, Downs JB, Malec DJ et al (1988) Real-time continuous estimation of gas exchange by dual oximetry. Intensive Care Med 14:118–122
Gould SA, Rice CL, Moss GS (1984) The physiologic basis of the use of blood and blood products. Surg Annual 16:13
Shoemaker WC, Appel P, Bland R (1983) Use of physiologic monitoring to predict outcome and to assist in clinical decisions in critically ill postoperative patients. Am J Surg 146:43–49
Hayes M, Yau EHS, Timmins AC et al (1993) Response of critically ill patients to treatment aimed at achieving supranormal oxygen delivery and consumption: Relationship to outcome. Chest 103(3):886–895
Levy PS, Chavez RP, Crystal GJ et al (1992) Oxygen extraction ratio: A valid indicator of transfusion need in limited coronary vascular reserve? J Trauma 32;6:769–774
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© 1999 Springer-Verlag Italia
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Lumb, P.D. (1999). Perioperative Care: Physiology and Practicality. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2145-7_11
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DOI: https://doi.org/10.1007/978-88-470-2145-7_11
Publisher Name: Springer, Milano
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