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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOMINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Periodicità: Mensile

ISSN 0375-9393

Online ISSN 1827-1596

 

Minerva Anestesiologica 2009 Maggio;75(5):325-7

 REVIEW ARTICLES

Patients with comorbidities: what shall we do to improve the outcome

Rossi M., Iemma D.

Department of Anesthesia, Intensive Care and Pain Medicine, Biomedical Science High Technology Research and Training Center “Giovanni Paolo II”, Sacro Cuore Catholic University, Campobasso, Italy

The number of patients submitted to major surgery affected by one or more comorbidities is progressively increasing. Outcome is the final output measured as morbidity, mortality and quality of life, of diagnostic tests, procedures, therapy tools started in the preoperative period and fitted on single patients or groups of patients or typology of surgical acts. Strategies to improve outcome can be divided in some fundamental steps: preoperative evaluation; optimization and no discontinuation of preoperative drug treatments, mainly in cardiac patient; choice of adequate monitoring techniques, checking of patient metabolic state and oxidative balance; choice of the best anesthesia; postoperative care, particularly due to identify the best management of the critical patient between the different levels of assistance. In conclusion, a patient with comorbidities scheduled for major surgery needs a full anesthetist-intensivist involvement, which broadens the role of the anesthetist in the perioperative medicine. Outcome is the result of many interventions during patient course, including economic costs and the importance of an appropriate treatment.

lingua: Inglese


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