Perioperative beta-blockers in high-risk patients.
One major risk to patients in the preoperative period is that of myocardial ischemia or infarction and cardiovascular death in high-risk patients. Historically, attempts to decrease the incidence of perioperative cardiac complications have focused on preoperative evaluation and identification of patients at risk for complications with referral for additional testing and/or revascularization. Evidence suggests that the use of perioperative beta-blockers in high-risk individuals can reduce the incidence of perioperative cardiac events. The Agency for Healthcare Research and Quality has identified that the use of perioperative beta-blockers can reduce perioperative morbidity and mortality. The focus of this article is to describe the evidence supporting perioperative beta-blocker use, to discuss potential barriers to their use, and to propose a strategy to improve their use.
Martinez
Elizabeth A
EA
Johns Hopkins University School of Medicine, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD 21287-7294, USA. emartine@jhmi.edu
Pronovost
Peter
P
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D009203:Myocardial Infarction / Q000517:prevention & control*; D017202:Myocardial Ischemia / Q000517:prevention & control*; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D014481:United States
D000319:Adrenergic beta-Antagonists