Clinical Perioperative Management — Medicine and Surgery

Surgery · Clinical Specialties

How it begins

Evaluación del riesgo multimodal, optimización fisiológica de sistemas orgánicos, control de la terapia antitrombótica y protocolos de recuperación acelerada basados en la evidencia clínica contemporánea y guías internacionales.

What it covers

1. Surgery: Perioperative Management
2. Global Surgical Risk Assessment
3. · Stratification of Physical Condition: American Society of Anesthesiologists (ASA) Scale
4. · Revised Cardiac Risk Index (RCRI or Lee Index)
5. · Evaluation of Functional Capacity and Metabolic Equivalents (METs)
6. · Multivariate Predictive Tools: NSQIP MICA Calculator
7. Physiological Response to Surgical Stress
8. · Afferent and Neuroendocrine Signaling Cascade
9. · Metabolic Response: Cuthbertson Phases
10. · The Immunological and Inflammatory Cascade
11. Evaluation and Cardiovascular Risk
12. · Evaluation Algorithm in Non-Cardiac Surgery (ESC/ESAIC Guidelines 2022)
13. · Classification of Procedures According to Intrinsic Cardiovascular Risk
14. · Indications for Preoperative Diagnostic Tests
15. · The Role of Cardiac Biomarkers: NT-proBNP and hs-cTn
16. Perioperative Cardiovascular Pharmacotherapy
17. · The Beta-Blocker Controversy: Lessons from the POISE-1 Trial
18. · ACEI and ARA-II: Continue or Suspend?
19. · Management of Statins and Diuretics
20. Management of Antithrombotic Therapy
21. · Double Antiplatelet Aggregation (DAPT) in Patients with Coronary Stents
22. · Management of Direct Acting Oral Anticoagulants (DOACs) and Vitamin K Antagonists
23. · Bridging Therapy: Indications after the BRIDGE Trial
24. Pulmonary Risk and Management
25. · Postoperative Pulmonary Complications (PPC)
26. · Pulmonary Risk Stratification: ARISCAT Scale
27. · Pathophysiology of Atelectasis and Diaphragmatic Dysfunction
28. · Pulmonary Prevention and Optimization Strategies
29. · Obstructive Sleep Apnea (OSA): STOP-BANG Screening Questionnaire
30. Kidney Function and Perioperative Hydration
31. · Postoperative Acute Kidney Injury (AKI)
32. · Perioperative Fluid Therapy: Liberal vs. Restrictive (RELIEF Trial)
33. · Goal Guided Fluid Therapy (GDTP / GDFT)
34. · Perioperative Sodium Disorders: Acute Hyponatremia
35. Glycemic Control and Endocrine Disorders
36. · Perioperative Glycemic Control: Lessons from the NICE-SUGAR Trial
37. · Management of Oral and Non-Insulin Antidiabetics
38. · Secondary Adrenal Insufficiency and Stress Steroid Therapy
39. Antimicrobial Prophylaxis and Infection Control
40. · Antibiotic Administration and Selection Criteria
41. · The 60 Minute Rule and Redosing Criteria
42. · Regimes of Choice according to Surgical Location
43. Hemostatic Management and Perioperative Transfusion
44. · Transfusion Strategy: Restrictive vs. Liberal (TRICS III Test)
45. · Viscoelastic Coagulation Tests: TEG and ROTEM
46. · Use of Perioperative Antifibrinolytics: POISE-3 Trial
47. Management of the Elderly and Frail Patient
48. · Frailty as an Independent Predictor of Complications
49. · Postoperative Delirium (POD) vs. Postoperative Cognitive Dysfunction (POCD)
50. · Non-Pharmacological Delirium Prevention Strategies (HELP Protocol)
51. · Polypharmacy and Inappropriate Prescription: Beers Criteria
52. ERAS / Fast-Track protocols
53. · Components of a Multimodal ERAS Protocol
54. Multimodal Analgesia and Pain Control
55. · The Multimodal Analgesia Paradigm
56. · Adverse Effects of Indiscriminate Use of Opioids
57. · Prevention and Management of Postoperative Nausea and Vomiting (PONV)
58. Major Postoperative Complications
59. · Postoperative Fever: The Diagnostic Rule of the "5 Ws"
60. · Venous Thromboembolism Prophylaxis: Caprini Scale
61. · Postoperative Paralytic Ileus and Anastomosis Dehiscence