Akute perioperative Organschädigung - Bedeutung, Diagnostik und Prävention = Acute perioperative organ damage-significance, diagnostics and prevention

The perioperative 30-day mortality rate of around 1 % represents a major chal-lenge in anaesthesiology. Acute perioperative organ injuries (APOI) play a decisive role. Perioperative myocardial injury, for example, occurs in approximately 16 % of cases after non-cardiosurgical operations and is assoc...

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Autori principali: Hölzer, Hans Thomas (Autore) , Weigand, Markus A. (Autore) , Horcicka, Anna (Autore)
Natura: Article (Journal)
Lingua:tedesco
Pubblicazione: Mai/Juni 2026
In: Anästhesiologie & Intensivmedizin
Year: 2026, Volume: 67, Pages: 172-183
ISSN:1439-0256
DOI:10.19224/ai2026.172
Accesso online:Verlag, kostenfrei, Volltext: https://dx.doi.org/10.19224/ai2026.172
Testo
Note sull'autore:H.T. Holzer, M.A. Weigand, A. Horcicka
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Riassunto:The perioperative 30-day mortality rate of around 1 % represents a major chal-lenge in anaesthesiology. Acute perioperative organ injuries (APOI) play a decisive role. Perioperative myocardial injury, for example, occurs in approximately 16 % of cases after non-cardiosurgical operations and is associated with a hazard ratio of 2.7 for mortality within 30 days post-surgery. Due to their fre-quently subclinical presentation, APOI often remain undiagnosed, yet they still have a significant impact on the healing process and can potentiate each other. Inflammatory and ischaemic conditions are assumed to be potential causes. APOI include perioperative myocardial injury, acute lung injury with ARDS, acute liver injury, acute kidney injury, and acute gut injury, as well as perioperative stroke and postoperative delirium. Measures to reduce mortality include the preoperative optimization of patients, for example by smoking cessation, pharmacological management of chronic diseases such as asthma, COPD, diabetes, hypertension and heart failure, treatment of iron deficiency anaemia with intravenous iron administration, and the diagnosis and management of obstructive sleep apnoea syndrome. Intraoperatively, attention should be paid to maintaining a stable fluid balance and the avoidance of hypotension. Postoperatively, hypoxia and hypotension should be closely monitored and prevented, and APOI should be screened and treated. A collaborative, interdisciplinary approach is essential for successful outcomes. At the same time, elective surgery can motivate patients to adjust and improve their lifestyle. The prevention, diagnosis and treatment of APOI are key elements in reducing perioperative mortality.
Descrizione del documento:Gesehen am 04.09.2026
Descrizione fisica:Online Resource
ISSN:1439-0256
DOI:10.19224/ai2026.172