Cardiovascular complications after non-cardiac surgery

被引：65

作者：

Sellers, D. ^{[1
]}

Srinivas, C. ^{[1
]}

Djaiani, G. ^{[1
]}

机构：

[1] Univ Toronto, Toronto Gen Hosp, Toronto, ON, Canada

来源：

ANAESTHESIA | 2018年 / 73卷

关键词：

non-cardiac surgery; complications; myocardial injury; POSTOPERATIVE ATRIAL-FIBRILLATION; PERCUTANEOUS CORONARY INTERVENTION; HIGH-SENSITIVITY TROPONIN; CALCIUM-CHANNEL BLOCKERS; ADVERSE CARDIAC EVENTS; ASSOCIATION TASK-FORCE; 2014 ACC/AHA GUIDELINE; MYOCARDIAL INJURY; QT INTERVAL; INTRAOPERATIVE HYPOTENSION;

D O I：

10.1111/anae.14138

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Cardiac complications are common after non-cardiac surgery. Peri-operative myocardial infarction occurs in 3% of patients undergoing major surgery. Recently, however, our understanding of the epidemiology of these cardiac events has broadened to include myocardial injury after non-cardiac surgery, diagnosed by an asymptomatic troponin rise, which also carries a poor prognosis. We review the causation of myocardial injury after non-cardiac surgery, with potential for prevention and treatment, based on currently available international guidelines and landmark studies. Postoperative arrhythmias are also a frequent cause of morbidity, with atrial fibrillation and QT-prolongation having specific relevance to the peri-operative period. Postoperative systolic heart failure is rare outside of myocardial infarction or cardiac surgery, but the impact of pre-operative diastolic dysfunction and its ability to cause postoperative heart failure is increasingly recognised. The latest evidence regarding diastolic dysfunction and the impact on non-cardiac surgery are examined to help guide fluid management for the non-cardiac anaesthetist.

引用

页码：34 / 42

页数：9

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