Perioperative Medicine

Readings and Practice

General Consult Issues

• Ten Commandments for Effective Consultations (Arch Int Med, 1983)

• Principles for Effective Consultation (Arch int Med, 2007)

• ASA Classification

• ASA III & IV

• VTE Risk Assessment-Caprini

• Preoperative Medical Assessment Reference (Montefiore document)

• Duke Activity Status Index (10.25 points = >4METS)

• Elements of the Preoperative Assessment

• Perioperative Medications - Gina Lee

• Postop Respiratory Failure Risk Index (Arozullah, Ann Surg 2000)

• Postop Respiratory Failure Risk Index (ARISCAT, Anesthes 2010)

• LP Checklist

UpToDate

General

• Preoperative medical evaluation of the healthy patient (Aug 2016)

• Perioperative medication management (Feb 2016)

• Overview of the principles of medical consultation and perioperative medicine (Sep 2016)

Cardiac

• Management of cardiac risk for noncardiac surgery (Sep 2016)

• Evaluation of cardiac risk prior to noncardiac surgery (June 2016)

• Perioperative myocardial infarction after noncardiac surgery (Nov 2016)

• Management of periop heart failure in patients undergoing noncardiac surgery (Feb 2016)

• Noncardiac surgery after percutaneous coronary intervention (May 2016)

• Perioperative management of hypertension (Sep 2016)

• Noncardiac surgery in patients with aortic stenosis (June 2016)

• Noncardiac surgery in patients with mitral or aortic regurgitation (Jul 2016)

Pulmonary

• Evaluation of preoperative pulmonary risk (Oct 2016)

• Strategies to reduce postoperative pulmonary complications (Feb 2016)

• Overview of the management of postoperative pulmonary complications (Oct 2016)

• Surgical risk and the preop evaluation and management of adults with OSA (Sep 2016)

• Postoperative management of adults with OSA (Apr 2016)

Infectious Disease

• Postoperative fever (Sep 2016)

• Antimicrobial prophylaxis for prevention of surgical site infection in adults (Nov 2016)

• Antimicrobial prophylaxis for bacterial endocarditis (Apr 2016)

• Surgical issues in HIV infection (Dec 2015)

Heme/Onc

• Perioperative management of patients receiving anticoagulants (Sep 2016)

• Preoperative evaluation and management of patients with cancer (Oct 2015)

• Preoperative assessment of hemostasis (Apr 2016)

• Prevention of venous thromboembolic disease in surgical patients (Oct 2016)

Endocrine

• Perioperative management of blood glucose in adults with diabetes mellitus (Sep 2016)

• The surgical patient taking glucocorticoids (Sep 2014)

• Nonthyroid surgery in the patient with thyroid disease (Apr 2015)

Other

• Medical consultation for patients with hip fracture (Aug 2016)

• Assessing surgical risk in patients with liver disease (Aug 2015)

• Preop evaluation & periop management of patients with rheumatic diseases (Oct 2016)

• Perioperative care of the surgical patient with neurologic disease (Sep 2014)

• Management of acute perioperative pain (Sep 2016)

• Identification and management of unhealthy ETOH use in the periop period (Apr 2016)

• Medical management of the dialysis patient undergoing surgery (Aug 2015)

• Overview of preoperative evaluation and preparation for gynecologic surgery (Sep 2016)

Guidelines

• Perioperative Evaluation and Care for Noncardiac Surgery, 2014

• Preoperative Beta Blockade, 2014

• Perioperative Management of Antithrombotic Therapy, Chest 2022

• Prevention of VTE in Nonorthopedic Surgical Patients, Chest 2012

• Prevention of VTE in Orthopedic Surgery Patients, Chest 2012

• Prevention of Infective Endocarditis, 2007

Cochrane Reviews

Beta Blockers

• Perioperative Beta Blockers for preventing surgery related mortality & morbidity (2014)

• Beta Blockers for periop cardiac risk reduction - vascular surgery (2015)

Statins

• Perioperative Statin therapy for improving outcomes during & after noncardiac vasc surg (2013)

• Preoperative statin therapy for patients undergoing cardiac surgery (2015)

• Statins for preventing AKI after surgical procedures requiring cardiac bypass (2015)

ACE/ARBs

• Perioperative ACE/ARB for preventing mortality & morbidity in adults (2016)

Postop Pulmonary Complications

• CPAP to prevent postop morbidity & mortality - major abdominal surgery (2014)

• Incentive spirometry for prevention of postop pulm complications - upper abdom surg (2014)

• Preop IMT for postop pulmonary complications in adults - cardiac & major abdom surg (2015)

Miscellaneous

• Interventions for protecting renal function in the perioperative period (2013)

• Preoperative blood transfusions for sickle cell disease (2012)

• Perioperative glycemic control for DM patients undergoing surgery (2012)

Journal Articles

Perioperative Cardiovascular Risk Assessment

• RCRI Derivation/Validation (Circulation 1999)

• Gupta Risk Calculator Derivation/Validation (Circulation 2011)

• Development & Evaluation of the Universal ACS NSQIP Surgical Risk Calculator (JACS, 2013)

• Vascular Study Group of New England Cardiac Risk Index (Journal of Vasc Surg, 2010)

• Systematic Review: RCRI (Annals, 2010)

Perioperative Cardiac Biomarkers & Postop MI

• Pre-op BNP as a Predictor of Cardiac Events (JACC, 2009)

• Characteristics & Short-Term Prognosis of Periop MI (Annals 2011)

• VISION - Postop Trops Predict 30-Day Mortality After Noncardiac Surg (JAMA, 2012)

Perioperative Beta Blockers

• POISE - Metoprolol succinate in patients undergoing non-cardiac surgery (Lancet, 2008)

• DiPOM - Metoprolol in Diabetics undergoing major non-cardiac surgery (BMJ 2006)

Periopertative Statins

• High Dose Statins & Perioperative CV Outcomes (JACC 2007)

Perioperative Revascularization

• CARP - Revascularization in Vascular Surgery (NEJM 2004)

Perioperative ASA & Clonidine

• ASA in patients undergoing noncardiac surgery - POISE-2 (NEJM 2014)

• Clonidine in patients undergoing noncardiac surgery - POISE-2 (NEJM 2014)

Perioperative Anticoagulation Management

• Periop bridging AC in Pts with AFib - BRIDGE (NEJM, 2015)

• Periop bridging of anticoagulant therapy (SHM consults)

Perioperative Anemia

• Liberal or Restrictive Transfusion in High-Risk Pts after Hip Surgery - FOCUS (NEJM, 2011)

• The Transfusion Alternatives Preoperatively in Sickle Cell Disease (TAPS) study (Lancet, 2013)

Postoperative Pulmonary Complications

• Multivariable Predictors of Postoperative Respiratory Failure after General and Vascular Surgery (ACS, 2007)