| Explanatory note |
Specific chronic conditions are taken into account in current evidence-based recommendations and investigated in systematic reviews (e.g. general advisory statements for obese patients undergoing surgery or more specific procedural recommendation like the skeletonized internal mammary artery harvesting in obese and/or diabetic patients to reduce the risk of wound infection, perioperative arterial pressure and glycaemic optimization, pharmacological and non-pharmacological interventions to protect kidneys; auto-immune diseases have been less thoroughly examined, still forms of vasculitis constitute a chapter in the ESC guidelines on aortic diseases. However, despite the abundancy of literature output on these themes, the broadness of the question and gaps still present in the evidence would probably advice for further research.
~ Does management of patients' co-morbidities like hypertension, diabetes change the risk profile in major cardiovascular surgery/anaesthesia? Does having an autoimmune disease increase the risk of complications during cardiac surgery? Does preoperative anaemia affect outcome from heart surgery? Effect of diabetes on outcomes of cardiac surgery? Effect of obesity on outcomes of cardiac surgery? |
| Evidence |
Sousa-Uva M, Head SJ, Milojevic M, Collet JP, Landoni G, Castella M, et al. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg. 2018;53(1):5-33; Zacharias M, Mugawar M, Herbison GP, Walker RJ, Hovhannisyan K, Sivalingam P, et al. Interventions for protecting renal function in the perioperative period. Cochrane Database of Systematic Reviews. 2013(9). Poirier P, Alpert MA, Fleisher LA, Thompson PD, Sugerman HJ, Burke LE, et al. Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circulation. 2009;120(1):86-95.
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