Ugeskrift for laeger
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Cardiac patients lack compensatory capacity during bleeding, pain, and infection with an increased risk of perioperative cardiac complications. The mortality following serious postoperative cardiac events is 1400 patients per year in Denmark. ⋯ Information about the patient's heart disease should be available and treatment optimated before surgery and anaesthesia. Evidence-based preoperative risk assessment and perioperative patient care for patients with heart disease and hypertension are summarised.
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Major surgical procedures are still beset with morbidity and hospitalisation. This short survey discusses different pathogenic factors that may contribute to morbidity, with an emphasis on surgical stress responses, pain relief and all-over perioperative care in accordance with the principles of fast-track surgery. It is emphasized that further advances require a multi-disciplinary approach with a focus on process organization and where sufficient quantity is available to secure anaesthesiological, surgical and nursing care expertise.
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Anaesthesia to obese patients is a challenge due to specific changes in respiratory and circulatory functions. Obese patients have a higher risk of acquiring nosocomial infections, including wound sepsis. ⋯ The risk induced from anaesthesia and surgery correlates with comorbidity rather than BMI. Obese patients should not be discriminated against when considering a surgical option.