Related Experiment Video
Updated: Mar 14, 2026
05:39
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
2.6K
Randomized Evidence for Reduction of Perioperative Mortality: An Updated Consensus Process
Giovanni Landoni1, Antonio Pisano2, Vladimir Lomivorotov3
1Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Journal of Cardiothoracic and Vascular Anesthesia
|October 4, 2016
Summary
Nonsurgical interventions can reduce perioperative mortality. Experts identified 13 such interventions, including hemodynamic optimization and tranexamic acid, with varying clinician agreement, highlighting potential for improved patient survival.
Area of Science:
- Perioperative Medicine
- Clinical Interventions
- Evidence-Based Practice
Background:
- Major surgery has high mortality rates, with over 1 million deaths annually.
- Nonsurgical interventions may significantly reduce perioperative mortality.
- Previous consensus processes have identified potential life-saving interventions.
Purpose of the Study:
- To update a consensus process identifying nonsurgical interventions supported by randomized evidence.
- To determine which interventions may reduce perioperative mortality.
- To assess global clinician agreement on these interventions.
Main Methods:
- A web-based international consensus conference involving 500 clinicians from 61 countries.
- Systematic literature search for randomized evidence on interventions impacting mortality.
- Expert discussion and global web-based survey of identified interventions.
Main Results:
- Eleven interventions were identified that may increase survival, including hemodynamic optimization, neuraxial anesthesia, and tranexamic acid.
- Two interventions, beta-blocker therapy and aprotinin, were associated with increased mortality.
- Significant differences in clinician agreement were observed across countries, indicating a gap between evidence and practice.
Conclusions:
- Thirteen nonsurgical interventions identified may decrease or increase perioperative mortality.
- Variable clinician agreement highlights the need for further discussion and guideline development.
- These interventions are candidates for high-quality trials to reduce perioperative mortality.
