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Biomarkers to guide perioperative management

Edwards, M; Whittle, J; Ackland, GL; (2011) Biomarkers to guide perioperative management. POSTGRAD MED J , 87 (1030) 542 - 549. 10.1136/pgmj.2010.107177.

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Abstract

Stratifying preoperative risk and guiding perioperative therapy objectively has acquired critical importance, given robust data demonstrating that morbidity following non-cardiac surgery confers substantially increased risk of death, even beyond hospital discharge. The development of useful perioperative biomarkers depends fundamentally on both prospective morbidity data that enable the identification of higher risk patients as well as the translational understanding of pathophysiological mechanisms underlying postoperative organ dysfunction, the development of which may be specific to the perioperative environment. The emergence of cardiac insufficiency, rather than cardiac ischaemia, as the dominant factor associated with excess risk of prolonged postoperative morbidity has promoted the application of biomarkers used commonly in cardiovascular medicine. Several novel, organ specific biomarkers offer potential perioperative application. Nevertheless, common tests/biomarkers that are widely available do provide valuable, objective information that is perhaps under-utilised perioperatively. Despite significant challenges, perioperative medicine presents exciting-arguably unique-opportunities for novel biomarker development.

Type:Article
Title:Biomarkers to guide perioperative management
DOI:10.1136/pgmj.2010.107177
Keywords:C-REACTIVE PROTEIN, BRAIN NATRIURETIC PEPTIDE, ELECTIVE ORTHOPEDIC-SURGERY, MAJOR NONCARDIAC SURGERY, CORONARY-ARTERY-DISEASE, CHRONIC KIDNEY-DISEASE, VASCULAR SURGICAL-PATIENTS, ADVERSE CARDIAC EVENTS, LONG-TERM SURVIVAL, PROSPECTIVE COHORT
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Medicine (Division of)
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)

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