دانلود کتاب پزشکی بعد از عمل مدیریت برای نتیجه

The practices of anesthesiology, surgery, and critical care are continuously improving. Through advances in each field, a number of patients with increasingly severe comorbidities are undergoing riskier and more complex operations and experiencing better outcomes. In recent years, intraoperative mortality has decreased by a factor of 10.1 Nonetheless, perioperative morbidity and mortality remain high. If perioperative mortality were classified as a disease, it would be the third leading cause of death in the United States.2 Thirty-day postoperative mortality after noncardiac surgery could be as high as 1% and 2% for inpatients in the United States.3,4 Despite an enhanced ability to effectively care for this growing high-risk group, these patients remain at substantial risk for the development of perioperative organ dysfunction—myocardial, pulmonary, neurologic, and renal. The degree of dysfunction ranges from mild (sometimes silent) and even undetected injury to profound organ injury, coma, or death. The implications of the more immediate and severe injury occurring in the perioperative period have long been identified, but only recently has it been noted that injury thought to be transient may have long-term consequences. This realization is at the core of this book. In this chapter, we focus on identifying perioperative morbidity and touch on strategies to prevent or to treat these complications, many of which will be described further in subsequent chapters.