• Curr Opin Crit Care · Jun 2001

    Review

    Cardiovascular optimization for high-risk surgery.

    • R J Wilson and I Woods.
    • Department of Anaesthetics and Intensive Care, York District Hospital, Wigginton Road, York YO31 8HE, UK. jonathan@critbase.demon.co.uk
    • Curr Opin Crit Care. 2001 Jun 1;7(3):195-9.

    AbstractControversy still exists concerning the strategy of targeting so-called supranormal levels of oxygen delivery as a means of improving outcome from high-risk surgery. The pathogenesis of postoperative morbidity is not fully defined; however, it seems likely that the gastrointestinal tract plays a pivotal role, particularly as a source of endotoxin, which is a potent stimulator of the inflammatory response. Delayed recovery of gastrointestinal function also is a major contributor to postoperative morbidity. Demonstration of a significant reduction in gut ischemia, endotoxemia, postoperative inflammatory response, and morbidity in a high-risk general surgical population as a result of perioperative hemodynamic optimization would be a highly worthwhile study.

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