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The Yin and Yang of Perioperative Medicine.
N Engl J Med. 2014 Mar 31;
Authors: Vaishnava P, Eagle KA
Abstract
The past four decades have seen remarkable progress in establishing best perioperative practices.(1) One of the challenges in improving perioperative care, however, is rooted in the interplay of the myriad interdependent, often opposing, mechanisms that contribute to perioperative myocardial infarction - excess bleeding, dramatic fluid shifts, unrelenting tachycardia, myocardial stress with fixed coronary obstruction, profound hypotension or hypertension, coronary plaque rupture, and coronary spasm. Strategies that mitigate one mechanism may lead to another. Devereaux et al. now report on two such strategies in the Journal - the perioperative use of aspirin and the perioperative use of clonidine in patients undergoing . . .
PMID: 24679063 [PubMed - as supplied by publisher]