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Revisão Produção Nacional Revisado por pares
BIBTEX RIS

Randomized Evidence for Reduction of Perioperative Mortality

2012; Elsevier BV; Volume: 26; Issue: 5 Linguagem: Inglês

10.1053/j.jvca.2012.04.018

ISSN

1532-8422

Autores

Giovanni Landoni, Reitze Rodseth, Francesco Santini, Martin Ponschab, Laura Ruggeri, Andrea Székely, Daniela Pasero, John Augoustides, Paolo A. Del Sarto, Łukasz J. Krzych, Antonio Corcione, Alexandre Slullitel, Luca Cabrini, Yannick Le Manach, Rui Almeida, Elena Bignami, Giuseppe Biondi‐Zoccai, Tiziana Bove, Fabio Caramelli, Claudia Cariello, Anna Carpanese, Luciano Clarizia, Marco Comis, Massimiliano Conte, Remo Daniel Covello, Vincenzo De Santis, Paolo Feltracco, Gianbeppe Giordano, Demetrio Pittarello, Leonardo Gottin, Fabio Guarracino, Andrea Morelli, Mario Musu, Giovanni Pala, Laura Pasin, Ivana Pezzoli, Gianluca Paternoster, Rossella Remedi, Agostino Roasio, Mariachiara Zucchetti, Flavia Petrini, Gabriele Finco, Marco Ranieri, Alberto Zangrillo,

Tópico(s)

Anesthesia and Sedative Agents

Resumo

With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence.A web-based international consensus conference.More than 1,000 physicians from 77 countries participated in this web-based consensus conference.Systematic literature searches (MEDLINE/PubMed, June 8, 2011) were used to identify the papers with a statistically significant effect on mortality together with contacts with experts. Interventions were considered eligible for evaluation if they (1) were published in peer-reviewed journals, (2) dealt with a nonsurgical intervention (drug/technique/strategy) in adult patients undergoing surgery, and (3) provided a statistically significant mortality increase or reduction as suggested by a randomized trial or meta-analysis of randomized trials.Fourteen interventions that might change perioperative mortality in adult surgery were identified. Interventions that might reduce mortality include chlorhexidine oral rinse, clonidine, insulin, intra-aortic balloon pump, leukodepletion, levosimendan, neuraxial anesthesia, noninvasive respiratory support, hemodynamic optimization, oxygen, selective decontamination of the digestive tract, and volatile anesthetics. In contrast, aprotinin and extended-release metoprolol might increase mortality.Future research and health care funding should be directed toward studying and evaluating these interventions.

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