Reduction of risk of perioperative complications in case of cardiac comorbidity

Abstract

The objective: based on the published data to describe the conceptual issues of the problem of perioperative cardiac complications in non-cardiac surgery.Results: changes made to international guidelines over the past 3–4 years based on evidence-based studies and meta-analyzes have been analyzed. The article presents data on the etiopathogenesis of various postoperative cardiac complications, assessment of their risk based on the evaluation of functional activities of patients, cardiac risk indices, and modern biomarkers (B-type natriuretic peptides, cardiospecific troponins). The contemporary recommendations on adjuvant pharmacological cardioprotection and rational pharmacotherapy in the perioperative period are analyzed. The article describes specific parameters of diagnostic, treatment and prevention tactics in patients with coronary heart disease, hypertension, chronic heart failure, heart defects, and implanted electronic devices. It concludes that the implementation of the comprehensive strategy aimed at the reduction of risk of pulmonary complications should ensure the decrease in their frequency and mortality due to them.

Keywords

• периоперационные кардиальные осложнения
• некардиальные операции
• кардиальная коморбидность
• инфаркт миокарда
• повреждение миокарда
• сердечная недостаточность
• натрийуретические пептиды
• адъювантная кардиопротекция