Surgery: Pathophysiological Bases and Perioperative Management

Surgery · Clinical Specialties

How it begins

Comprehensive study of the systemic response to surgical aggression, the evaluation and optimization of perioperative risk, and the rational management of the surgical patient from preoperative assessment to postoperative recovery.

What it covers

1. Pathophysiological Bases and Perioperative Management
2. The Surgical Patient as a Model of Physiological Stress
3. Metabolic Phases of the Surgical Response: Cuthbertson and Moore
4. · Cuthbertson's two-phase model: "Ebb and Flow"
5. Neuroendocrine Response to Surgical Aggression
6. · Sympathetic nervous system and catecholamines
7. · Hypothalamic-pituitary-adrenal axis
8. Systemic Inflammatory Response to Surgical Trauma
9. · Cytokine cascade
10. · Acute phase proteins
11. · SIRS and its relationship with surgical trauma
12. Catabolism and Substrate Metabolism in the Surgical Patient
13. · Stress hyperglycemia
14. · Protein catabolism and nitrogen balance
15. · Lipid metabolism
16. Perioperative Hydroelectrolyte Balance Alterations
17. · The "third space" phenomenon
18. · Sodium and water retention
19. · Potassium alterations
20. Perioperative Thermoregulation and Inadvertent Hypothermia
21. · Clinical consequences of perioperative hypothermia
22. Coagulation and Postoperative Prothrombotic State
23. · VTE risk stratification and prophylaxis
24. Preoperative Surgical Risk Assessment
25. · ASA Classification (American Society of Anesthesiologists)
26. · Assessment of cardiovascular risk
27. · Pulmonary risk assessment
28. Preoperative Optimization of Comorbidities
29. · Perioperative management of diabetes mellitus
30. · Management of chronic anticoagulation (bridging)
31. · Correction of preoperative anemia
32. · Surgical prehabilitation
33. Perioperative Fluid Therapy
34. · Crystaloids vs. colloids
35. · Fluid therapy strategies: restrictive vs. liberal vs. goal-directed
36. · Replacement of blood loss
37. Intraoperative Hemodynamic Management and Monitoring
38. · Intraoperative hypotension and organ damage
39. · Advanced hemodynamic monitoring
40. · Management of blood pressure and vasopressors
41. Postoperative Multimodal Analgesia
42. · Components of multimodal analgesia
43. ERAS Programs (Enhanced Recovery After Surgery)
44. · Key components of an ERAS protocol
45. Systemic Postoperative Complications
46. · Respiratory complications
47. · Kidney complications
48. · Complications of the surgical wound
49. · Postoperative delirium
50. Postoperative Ileus and Nutritional Support
51. · Perioperative nutritional support
52. Postoperative Fever: The "5 W" Approach