Improving Outcome After Major Surgery: Pathophysiological Considerations

Banz, Vanessa M; Jakob, Stephan M; Inderbitzin, Daniel (2011). Improving Outcome After Major Surgery: Pathophysiological Considerations. Anesthesia and analgesia, 112(5), pp. 1147-55. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1213/ANE.0b013e3181ed114e

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Surgical and anesthesia-related techniques may reduce physical stress for patients undergoing high-risk surgery, but major surgery is increasingly performed in patients with substantial comorbidities. Strategies for improving the outcome for such patients include approaches that both increase tissue oxygen delivery and reduce metabolic demand. However, these strategies have produced conflicting results. To understand the success and failure of attempts to improve postoperative outcome, the pathophysiology of perioperative hemodynamic, metabolic, and immunological alterations should be analyzed. Our aim in this review is to provide a survey of fields of opportunities for improving outcome after major surgery. The issues are approached from 3 different angles: the view of the patient, the view of the surgical intervention, and the view of the anesthesia. Special attention is also given to what could be considered the result of the interaction among the 3: perioperative inflammation and immune response.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Jakob, Stephan and Inderbitzin, Daniel

ISSN:

0003-2999

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:09

Last Modified:

06 Dec 2013 13:20

Publisher DOI:

10.1213/ANE.0b013e3181ed114e

PubMed ID:

20736438

Web of Science ID:

000289785100022

URI:

https://boris.unibe.ch/id/eprint/837 (FactScience: 200984)

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