By M. Greher, H. Tschernich, M. Zimpfer (auth.), Prof. Antonino Gullo M.D. (eds.)
Continuous replace in serious care medication is a true problem a result of turning out to be dimensions of its contents; those parts are the results of new study acquisitions, and of these scientific occasions the place the health care provider is ready to intrude at a given second, with using potent prevention options. also they are the results of new applied sciences in a position to outline advanced sub-clinical diagnostic elements; finally, they're the results of potent healing innovations on hand, and of remedy innovations in a position to impact greatly and definitely the patient's scientific direction. severe care drugs is enjoying a key position within the so much complicated environments, because it represents a cross-sectional box of motion, regarding numerous specialties, resembling anesthesiology, basic medication, surgical procedure, pediatrics.
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Extra info for Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.: Proceedings of the 18th Postgraduate Course in Critical Care Medicine Trieste, Italy — November 14–17, 2003 Volume II
Acta Anaesthesiol Scand 42:316-322 27. McKee RF, Scott EM (1987) The value of routine preoperative investigations. Ann R ColI Surg EngI69:160-162 28. Narr BJ, Warner ME, Schroeder DR et al (1997) Outcomes of patients with no laboratory assessment before anesthesia and a surgical procedure. Mayo Clin Proc 72:505-509 29. Schein OD, Katz J, Bass EB et al (2000) The value of routine preoperative medical testing before cataract surgery. Study of medical testing for cataract surgery. N Engl J Med 342: 168-175 30.
LIr~lcul 2 ·3 4 S 8 c1ioical pro dietoes? 9. Nonin\'l$ive testins proiti",,? ll n .. 1.. u "ron·dun .. COAtidei' invasive 1••08, if oeptivo OR OR M Greh ... 2003 Fig. 2An adapted preoperative cardiac evaluation algorithm, considering cardiovascular risk factors, functional capacity and type of surgery (following the Ace/AHA - Guidelines 2002) 694 M. Greher, H. Tschemich, M. Zimpfer stress testing is considered a class 1 indication for diagnosis of adult patients with intermediate pretest probability of coronary artery disease [31-37].
Preoperative assessment in the future With the introduction of functional genomics, a new age of perioperative risk factor identification has risen. Recently, Donahue et al.  have shown a linkage between the factor V Leiden polymorphism and a nearly 30% reduction in blood loss following cardiac surgery. An excellent review  of the 696 M. Greher, H. Tschemich, M. Zimpfer influence of genotype on perioperative risk and outcome - including inflammation, infection, thrombosis or vascular reactivity ~ gives an insight into current knowledge and future implications for anaesthesiology.