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The perioperative period is characterized by an intense inflammatory response marked by elevated concentrations of inflammatory markers like C-reactive protein (CRP). This response has been linked to increased perioperative morbidity and mortality. Available evidence suggests that blunting the inflammatory response to surgery might improve perioperative outcomes. The benefits from blunting the surgical stress response are likely to be greatest in the high risk patient such as those having major non-cardiac surgery.
We will study three interventions potentially modulating perioperative inflammation, corticosteroids, tight glucose control and light anesthesia and their effects on major morbidity and mortality resulting from major non-cardiac surgery.
Allocation: Randomized, Control: Placebo Control, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Major Non-Cardiac Surgery
intensive glucose management, deeper anesthetic management, placebo, Dexamethasone, conventional glucose control, Lighter anesthesia group
Cleveland Clinic Foundation
Aspect Medical Systems
Published on BioPortfolio: 2014-07-23T21:30:12-0400
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Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
Business management of medical and dental practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.
Management review designed to evaluate efficiency and to identify areas in need of management improvement within the institution in order to ensure effectiveness in meeting organizational goals.
Voluntarily-formed groups of healthcare professionals who join for common management services and other benefits such as collective bargaining agreements with reimbursement agents. The physical assets of a practice are controlled by the MSO which also provides billing, collections, and similar services. The practitioner retains control of patient records and management of patient care.
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...