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Randomized Evidence for Reduction of Perioperative Mortality
Authors
Rm Almeida
Jg Augoustides
+42 more
E Bignami
G Biondi-Zoccai
T Bove
L Cabrini
F Caramelli
C Cariello
A Carpanese
L Clarizia
M Comis
M Conte
A Corcione
Rd Covello
V De Santis
Pa Del Sarto
P Feltracco
G Finco
G Giordano
L Gottin
F Guerracino
Lj Krzych
G Landoni
Y Le Manach
A Morelli
M Nusu
G Pala
D Pasero
L Pasin
G Paternoster
F Petrini
I Pezzoli
D Pittarello
M Ponschab
M Ranieri
R Remedi
A Roasio
Rn Rodseth
L Ruggeri
F Santini
A Slullitel
A Szekely
A Zangrillo
M Zucchetti
Publication date
1 January 2012
Publisher
'Elsevier BV'
Doi
Cite
Abstract
Objective: With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence. Design and Setting: A web-based international consensus conference. Participants: More than 1,000 physicians from 77 countries participated in this web-based consensus conference. Interventions: Systematic literature searches (MEDLINE/PubMed, June 8, 2011) were used to identify the papers with a statistically significant effect on mortality together with contacts with experts. Interventions were considered eligible for evaluation if they (1) were published in peer-reviewed journals, (2) dealt with a nonsurgical intervention (drug/technique/strategy) in adult patients undergoing surgery, and (3) provided a statistically significant mortality increase or reduction as suggested by a randomized trial or meta-analysis of randomized trials. Measurements and Main Results: Fourteen interventions that might change perioperative mortality in adult surgery were identified. Interventions that might reduce mortality include chlorhexidine oral rinse, clonidine, insulin, intra-aortic balloon pump, leukodepletion, levosimendan, neuraxial anesthesia, noninvasive respiratory support, hemodynamic optimization, oxygen, selective decontamination of the digestive tract, and volatile anesthetics. In contrast, aprotinin and extended-release metoprolol might increase mortality. Conclusions: Future research and health care funding should be directed toward studying and evaluating these interventions. © 2012 Elsevier Inc
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Archivio istituzionale della Ricerca - Università degli Studi di Parma
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oai:air.unipr.it:11381/2838856
Last time updated on 09/07/2019
Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna
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oai:cris.unibo.it:11585/663549
Last time updated on 04/09/2019
Archivio istituzionale della ricerca - Università degli Studi di Udine
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oai:air.uniud.it:11390/1122967
Last time updated on 10/04/2018