Preoperative Evaluation, An Issue of Anesthesiology Clinics, 1e: Volume 34-1 (The Clinics: Internal Medicine)

Description:

This issue of Anesthesiology Clinics focuses on Preoperative Evaluation.Topics will include: Preoperative Clinics, Consultations,Informed Consent/Shared Decision Making, Preoperative Labs,Evaluation of Major Organ Systems, Special Considerations, and Innovative treatment/preparation programs

Forthcoming Issues

Recent Issues

Foreword. Preoperative Evaluation—Can We Really Make a Difference in Outcomes?

Preface. Preoperative Evaluation

References

Section I: Introductory Articles

Preoperative Clinics

Key points

Introduction

History/background

Benefits and outcomes

Developing preoperative programs

Scope

Tactical and operational plans

Specific services delivered

Identifying resources

Summary

References

Preoperative Consultations

Key points

Introduction

The purpose of consultation

Current use of preoperative medical consultations

The cost of preoperative medical consultations

Coordination of perioperative care

Medicolegal aspects

Outcomes and preoperative medical consultations

Recommendations

Summary

References

Perioperative Ethical Issues

Key points

Shared decision-making

Do not resuscitate in the operating room

References

Preoperative Laboratory Testing

Key points

Test grid studies

Role of age

Electrocardiogram

Highly sensitive troponin

Natriuretic peptides

Renal function testing

Preoperative urine analyses

Preoperative pregnancy testing

Testing for blood glucose and glycated hemoglobin

Hematocrit

Coagulation studies

Genetic testing

Summary

References

Section II: Evaluation of Major Organ Systems

Preoperative Assessment of the Patient with Cardiac Disease Undergoing Noncardiac Surgery

Key points

Clinical assessment

Importance of the operative procedure

Importance of exercise tolerance

Approach to the patient

Choice of diagnostic test

Interventions for patients with documented coronary artery disease

Summary

References

Preoperative Evaluation: Estimation of Pulmonary Risk

Key points

Introduction

Pulmonary pathophysiology in the perioperative period

Definition of postoperative pulmonary complications

Preoperative risk assessment

Pulmonary risk factors

Nonpulmonary factors

Procedure-related risk factors for postoperative pulmonary complications

Physical examination

Preoperative pulmonary tests

Risk scores

Perioperative strategies to decrease postoperative pulmonary complications

Summary

References

Stratification and Risk Reduction of Perioperative Acute Kidney Injury

Key points

Definition

Epidemiology

Risk stratification based on surgical setting

Prognosis

Early diagnosis/novel biomarkers

Renal protection strategies

Summary and recommendations

References

Perioperative Approach to Anticoagulants and Hematologic Disorders

Key points

Coagulation disorders

Venous thromboembolism risk stratification and prevention

Perioperative management of the patient on chronic anticoagulant therapy

References

Section III: Innovative Treatment / Preparation Programs

Preoperative Anemia: Evaluation and Treatment

Key points

Introduction

Preoperative optimization of patients and anemia evaluation

Preoperative anemia, perioperative blood transfusions, and postoperative outcomes

Evaluation for anemia

Treatment of anemia

Preoperative anemia management in patients with sickle cell disease

Patient blood management

Summary

References

Preoperative Nutrition and Prehabilitation

Key points

Introduction

Preoperative nutrition assessment and optimization

Detecting malnutrition before surgery

Role of total parenteral nutrition

Avoiding insulin resistance and postoperative hyperglycemia

Immunonutrition

Prehabilitation: physical activity and health outcomes

Prehabilitation: exercise training before a physiologic challenge

Exercise programs

Summary

References

Section IV: Special Considerations

Preoperative Evaluation of Patients with Diabetes Mellitus

Key points

Introduction

Patient evaluation overview

Comorbidities associated with diabetes mellitus

Medication considerations

Physical examination considerations for the anesthesiologist

Summary/discussion

References

Preoperative Assessment of Geriatric Patients

Key points

Introduction

Neurocognitive and behavioral assessment

Cardiac evaluation

Pulmonary evaluation

Functional assessment

Delirium

Medication management

Nutrition

Frailty

Comprehensive geriatric assessment

The decision for surgery

References

Implantable Devices: Assessment and Perioperative Management

Key points

Introduction

Cardiovascular implantable electronic devices

Ventricular assist devices

Neurostimulators

Other implantable devices

Summary

References

Preoperative Evaluation of the Patient with Substance Use Disorder and Perioperative Considerations

Key points

Substance use disorder patient

Specific abused substances

Postoperative risk of new or relapsed substance abuse

Summary

References

The Pregnant Patient: Assessment and Perioperative Management

Key points

Physiologic changes of pregnancy

Maternal effects of anesthesia and surgery or procedures

Fetal effects of anesthesia and surgery or procedures and pregnancy outcomes

Nonobstetric surgeries or procedures requiring anesthesia that occur during pregnancy

Preoperative recommendations

Intraoperative recommendations

Postoperative recommendations

Preoperative pregnancy testing

Summary

References

Non-operating Room Anesthesia: The Principles of Patient Assessment and Preparation

Key points

Introduction

Challenges of non-operating room procedures

Quality assurance

Adding value as anesthesiologists

Anesthesia versus procedural sedation

Assessment of out-of-the-operating room environment

Preoperative patient assessment

Cardiovascular assessment

Pulmonary assessment

Gastrointestinal assessment

Renal assessment

Obstetric assessment

Procedural assessment

Diagnostic testing

Preprocedural medication management

Future directions

Summary

References

Index