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Surgical Intensive Care Medicine pp 107–111Cite as

Optimization of the High-Risk Surgical Patient

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Abstract

The normal acute physiological response to critical illness is to increase the oxygen delivery and consumption. Normal values are considered abnormal in the context of acute critical illness, and patients who achieve specific supra-normal hemodynamic variables have a better outcome. This forms the basis of optimization as these hemodynamic variables attained by survivors become a therapeutic target that achieved artificially by the use of intravenous fluids and inotropes under the guidance of cardiac output monitoring. This approach has been shown to improve the tissue oxygenation and prevents organ dysfunction and death in the high-risk patients undergoing major surgery.1,2 This chapter focuses on the perioperative optimization and the reader should refer to relevant chapters for the specific management of trauma and sepsis.

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Author information

Authors and Affiliations

  1. Anaesthesia and Intensive Care Medicine, St. George’s Hospital, London, UK

    Nawaf Al-Subaie

  2. Department of Intensive Care Medicine, St. George’s Hospital, London, UK

    Andrew Rhodes

Authors
  1. Nawaf Al-Subaie
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  2. Andrew Rhodes
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Editor information

Editors and Affiliations

  1. Department of Surgical Critical Care Division of Surgery, The Lahey Clinic Medical Center, Burlington, MA, USA

    John M. O’Donnell (Director, Surgical Intensive Care Unit Chairman) (Director, Surgical Intensive Care Unit Chairman)

  2. University Hospital Intensive Care Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Flávio E. Nácul

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Al-Subaie, N., Rhodes, A. (2010). Optimization of the High-Risk Surgical Patient. In: O’Donnell, J.M., Nácul, F.E. (eds) Surgical Intensive Care Medicine. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-77893-8_11

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  • DOI: https://doi.org/10.1007/978-0-387-77893-8_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-77892-1

  • Online ISBN: 978-0-387-77893-8

  • eBook Packages: MedicineMedicine (R0)

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