Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Belzberg, H.
Right arrow Articles by Rivkind, A. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Belzberg, H.
Right arrow Articles by Rivkind, A. I.
(Chest. 1999;115:82S-95S.)
© 1999 American College of Chest Physicians

Preoperative Cardiac Preparation*

Howard Belzberg, MD, FCCP and Avraham I. Rivkind, MD

* From the Division of Trauma/Critical Care, Department of Surgery, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA.

Correspondence to: Howard Belzberg, MD, FCCP, LAC + USC Medical Center, 1200 N State St, Room 9900, Los Angeles, CA 90033-4525; e-mail: belzberg{at}hsc.usc.edu

Preoperative preparation of the cardiac patient is based on matching the cardiac reserve to the blood flow demands imposed by surgical stress and the underlying disease state. Evaluation must include functional assessment of any coronary artery disease or other organic cardiac disease that may place myocardial tissue at risk of ischemia as demand for cardiac output increases. Monitoring should be individualized based on anticipated problems and the risk assessment of the patient. Preoperative therapy should include maneuvers that reduce congestive heart failure, optimize volume status, and provide adequate cardiac output to deliver oxygen sufficient to meet or exceed demand. Underlying electrical and metabolic abnormalities should be corrected and controlled in the perioperative period. Long-term therapy should be evaluated and modified in the context of the anesthetic and surgical plan. Preventive interventions such as fluid loading and low-dose dopamine should be considered prior to surgery.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1999 by the American College of Chest Physicians.