Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Introduction
- Risk Scoring and ICU Triage
- Pre-optimisation/Prehabilitation
- Intraoperative Care
- Perioperative Fluid Management
- Post-operative Care
- Evidence for Intensive Care in High-Risk Surgical Patients
- Conclusion
- Introduction
- Handover
- Examination
- Investigations in the Post-operative Setting
- Introduction
- Criteria for CCU Admission Following Craniotomy
- Interventions Requiring CCU Admission
- Complications Requiring CCU Admission
- Pain Management
- Conclusion
- Introduction
- Cardiovascular
- Renal Failure
- Hepatorenal Syndrome
- Ventilation
- Allograft Function
- Infection
- Nutrition
- Post-operative Complications in the ICU
- Introduction
- Monitoring
- Haemodynamics
- Right Ventricular Failure
- Rate and Rhythm
- Fluids and Renal Function
- Bleeding
- Immunosuppression and Infection
- Acute Rejection
- Non-cardiac Surgery in Heart Transplant Patients
- Introduction
- Surgery and Monitoring
- Management after Lung Transplant
- Complications after Lung Transplant
- Introduction
- Severity of Injury
- Problems and Treatment Strategies in the ICU
- Introduction
- Multi-modal, Opioid-Sparing Analgesia
- Effective Circulating Volume/Adequate Resuscitation
- Addressing the Need for Anti-microbial Treatment
- Nutritional Support
- Prophylaxis against ICU Complications
- Abdominal Catastrophes
- 6.1 Management of Pre- and Post-operative Care of the High-Risk Surgical Patient
- 6.2 Management of the Critical Care Patient Following Cardiac Surgery
- 6.3 Management of the Critical Care Patient Following Craniotomy
- 6.4 Management of the Critical Care Patient Following Liver Transplant
- 6.5 Management of the Critical Care Patient Following Heart Transplant
- 6.6 Management of the Critical Care Patient Following Lung Transplant
- 6.7 Pre- and Post-operative Management of the Critical Care Trauma Patient
- 6.8 Management of the Critical Care Patient Following Major Abdominal Surgery
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
6.1 - Management of Pre- and Post-operative Care of the High-Risk Surgical Patient
from Section 6 - Perioperative Care
Published online by Cambridge University Press: 27 July 2023
By
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Introduction
- Risk Scoring and ICU Triage
- Pre-optimisation/Prehabilitation
- Intraoperative Care
- Perioperative Fluid Management
- Post-operative Care
- Evidence for Intensive Care in High-Risk Surgical Patients
- Conclusion
- Introduction
- Handover
- Examination
- Investigations in the Post-operative Setting
- Introduction
- Criteria for CCU Admission Following Craniotomy
- Interventions Requiring CCU Admission
- Complications Requiring CCU Admission
- Pain Management
- Conclusion
- Introduction
- Cardiovascular
- Renal Failure
- Hepatorenal Syndrome
- Ventilation
- Allograft Function
- Infection
- Nutrition
- Post-operative Complications in the ICU
- Introduction
- Monitoring
- Haemodynamics
- Right Ventricular Failure
- Rate and Rhythm
- Fluids and Renal Function
- Bleeding
- Immunosuppression and Infection
- Acute Rejection
- Non-cardiac Surgery in Heart Transplant Patients
- Introduction
- Surgery and Monitoring
- Management after Lung Transplant
- Complications after Lung Transplant
- Introduction
- Severity of Injury
- Problems and Treatment Strategies in the ICU
- Introduction
- Multi-modal, Opioid-Sparing Analgesia
- Effective Circulating Volume/Adequate Resuscitation
- Addressing the Need for Anti-microbial Treatment
- Nutritional Support
- Prophylaxis against ICU Complications
- Abdominal Catastrophes
- 6.1 Management of Pre- and Post-operative Care of the High-Risk Surgical Patient
- 6.2 Management of the Critical Care Patient Following Cardiac Surgery
- 6.3 Management of the Critical Care Patient Following Craniotomy
- 6.4 Management of the Critical Care Patient Following Liver Transplant
- 6.5 Management of the Critical Care Patient Following Heart Transplant
- 6.6 Management of the Critical Care Patient Following Lung Transplant
- 6.7 Pre- and Post-operative Management of the Critical Care Trauma Patient
- 6.8 Management of the Critical Care Patient Following Major Abdominal Surgery
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. High-risk surgery is associated with significant inpatient mortality, and post-operative morbidity is associated with increases in long-term morbidity and mortality.
2. Perioperative care should be a team effort and proactive, rather than reactive.
3. Adequate risk assessment and ICU care triage are key to effective perioperative care.
4. Care bundles may reduce risk across a variety of surgeries and medical conditions through the aggregation of marginal gains.
5. Clear handover in the ICU can reduce medical error and improve patient safety.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 623 - 626Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Fleisher, LA, Fleischmann, KE, Auerbach, AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation 2014;130:e278–333.Google Scholar
Pearse, RM, Holt, PJE, Grocott, MPW. Managing perioperative risk in patients undergoing elective non-cardiac surgery. BMJ 2011;343:d5759.CrossRefGoogle ScholarPubMed
Pearse, RM, Moreno, RP, Bauer, P, et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet 2012;380:1059–65.CrossRefGoogle ScholarPubMed
Sobol, JB, Wunsch, H. Triage of high-risk surgical patients for intensive care. Crit Care 2011;15:217.CrossRefGoogle ScholarPubMed
The Royal College of Anaesthetists. 2015. Perioperative medicine: the pathway to better surgical care. www.rcoa.ac.uk/sites/default/files/documents/2019-08/Perioperative%20Medicine%20-%20The%20Pathway%20to%20Better%20Care.pdfGoogle Scholar