Perioperative Medicine

Prevention of Perioperative Surgical Site Infection

Introduction Surgical site infections (SSIs) are now the most common cause of hospital-acquired infections (HAIs), accounting for approximately 20% of all HAIs in hospitalized patients. Approximately 160,000–300,000 SSIs occur each year in the United States and 2%–5% occur in patients…

Perioperative Management of Bleeding and Transfusion

Introduction Transfusion therapy is necessary and can be lifesaving in surgical patients. However, despite being the standard of care for blood loss and anemia, it has never undergone the rigorous, randomized testing required of a new therapeutic agent, including assessment…

Prevention and Treatment of Gastrointestinal Morbidity

Undergoing general anesthesia for an elective operation has become exceedingly safe and is now rarely associated with mortality. With the improvements in perioperative screening, risk reduction, and intraoperative management, we can now focus on and improve the quality of postoperative…

Preservation of Spinal Cord Function

Introduction Acute spinal cord injury (SCI) is a devastating medical condition because of the impact of permanent disability produced by paraplegia or quadriplegia. Treatment of the initial injury and reintegration of the injured patient into society place a large burden…

Protecting the Central Nervous System During Cardiac Surgery

Introduction Multiple advances in perioperative techniques, especially the maturation of cardiopulmonary bypass, have allowed the practice of cardiac surgery to develop rapidly. Despite these advances that have enabled contemporary cardiac surgery to address a diverse range of cardiac pathologies, neurological…

Carotid and Intracranial Surgery

Anesthesia for Carotid Surgery In the United States, each year approximately 795,000 people experience a new or recurrent stroke. Approximately 610,000 of these were first attacks and 185,000 were recurrent attacks. In 2016 the age-adjusted death rate for stroke as…

Perioperative Management of Renal Failure and Renal Transplant

Introduction Safely guiding the patient with renal failure through the perioperative period presents a challenging set of problems such as the substantial comorbidity associated with chronic kidney disease (CKD), the risk of acute kidney injury (AKI), management of perioperative dialysis,…