Post-operative intensive care: is it really necessary?
It is estimated that more than 310 million patients receive a surgical treatment each year , and the number of procedures performed each year is growing [2, 3, 4, 5, 6]. Despite a majority of cases being performed without significant complication, deaths after surgery have recently been demonstrated to account for a large proportion of all deaths worldwide . For a minority of patients, surgical procedures carry a significant burden of both death and disability. High-risk patients account for approximately 10–15% of the surgical population, but suffer around 80% of post-operative deaths [4, 8]. These high-risk patients have only been loosely defined, being typically older with a higher burden of comorbid disease. The surgical population is ageing at a faster rate than the background population . With increasing numbers of procedures on increasingly high-risk patients, there is a clear need to identify possible interventions that improve peri-operative outcomes [4, 9], with...
RP is supported by an NIHR Research Professorship. AJF is supported by an NIHR Doctoral Research Fellowship (DRF-2018-11-ST2-062).
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Conflicts of interest
RP holds research grants, has given lectures, and/or performed consultancy work for Nestle Health Sciences, BBraun, Medtronic, Glaxo SmithKline, Intersurgical, and Edwards Lifesciences. All the other authors declare no conflicts of interest.
- 6.Edwards MR, Forbes G, MacDonald N et al (2019) Optimisation of perioperative cardiovascular management to improve surgical outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery. BMJ Open 9:e023455. https://doi.org/10.1136/bmjopen-2018-023455 CrossRefPubMedPubMedCentralGoogle Scholar