title: Peri-operative beta-blockade and haemodynamic optimisation in patients with coronary artery disease and decreasing exercise capacity presenting for major noncardiac surgery.
abstract: Patients with coronary artery disease presenting for major noncardiac surgery may have indications for both peri-operative beta-blockade and haemodynamic optimisation. The combination of peri-operative cardiorespiratory failure and myocardial ischaemia has a grave prognosis. Recent investigations have shown that in patients with coronary artery disease, beta-blockade does not depress cardiac output as much as originally thought. There may, therefore, be a place for both peri-operative beta-blockade and haemodynamic optimisation. The indications for peri-operative beta-blockade and haemodynamic optimisation, the effect of acute beta-blockade on cardiac output in patients with coronary artery disease, and the interaction of peri-operative beta-blockade and haemodynamic optimisation are discussed.
authors.affiliation: Consultant Anaesthetist, Department of Anaesthetics, Nelson R Mandela School of Medicine, Private Bag 7, Congella, 4013, South Africa. brucepen@samedical.co.za
authors.forename: B M
authors.initials: BM
authors.lastname: Biccard
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002302:Cardiac Output / Q000187:drug effects; D003324:Coronary Artery Disease / Q000503:physiopathology*; D017079:Exercise Tolerance; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D019990:Perioperative Care / Q000379:methods*; D013514:Surgical Procedures, Operative
chemical_list: D000319:Adrenergic beta-Antagonists