کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2760333 1150171 2012 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Randomized Evidence for Reduction of Perioperative Mortality
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
پیش نمایش صفحه اول مقاله
Randomized Evidence for Reduction of Perioperative Mortality
چکیده انگلیسی

ObjectiveWith more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence.Design and SettingA web-based international consensus conference.ParticipantsMore than 1,000 physicians from 77 countries participated in this web-based consensus conference.InterventionsSystematic literature searches (MEDLINE/PubMed, June 8, 2011) were used to identify the papers with a statistically significant effect on mortality together with contacts with experts. Interventions were considered eligible for evaluation if they (1) were published in peer-reviewed journals, (2) dealt with a nonsurgical intervention (drug/technique/strategy) in adult patients undergoing surgery, and (3) provided a statistically significant mortality increase or reduction as suggested by a randomized trial or meta-analysis of randomized trials.Measurements and Main ResultsFourteen interventions that might change perioperative mortality in adult surgery were identified. Interventions that might reduce mortality include chlorhexidine oral rinse, clonidine, insulin, intra-aortic balloon pump, leukodepletion, levosimendan, neuraxial anesthesia, noninvasive respiratory support, hemodynamic optimization, oxygen, selective decontamination of the digestive tract, and volatile anesthetics. In contrast, aprotinin and extended-release metoprolol might increase mortality.ConclusionsFuture research and health care funding should be directed toward studying and evaluating these interventions.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Cardiothoracic and Vascular Anesthesia - Volume 26, Issue 5, October 2012, Pages 764–772
نویسندگان
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