As physicians who protect and regulate patients’ critical life functions, anesthesiologists are committed to reducing the risk of surgical complications.

Two review articles from the December issue of Anesthesiology analyze evidence for the perioperative risks of heart attacks and sepsis after surgery.

Blockers and Genetics

More than 100,000 patients in the U.S. suffer from heart attacks each year within the first days after surgery. Forty percent of these patients do not survive. To address this, β-blockers, one of the most commonly prescribed drugs in the treatment of high blood pressure, are routinely used to prevent heart attacks.

However, the use of β-blockers has come under recent scrutiny. A large study in 2008 found that while β-blockers reduce the risk for postoperative heart attacks, they increase the overall rates for death and stroke. To better understand the risk of β-blockers, an Anesthesiology review article looked at whether genetic variation has an impact on the protective effects of β-blockers.

Our review article found strong evidence to suggest that the individual genetic background of a patient may have a substantial influence in how effective, but also dangerous, the use of β-blockers in the prevention of heart attacks is after surgery,” Peter Nagele M.D

Advances in Sepsis Therapy

Anesthesiologists are increasingly confronting the difficult problem of managing patients with sepsis as an estimated 40 percent of all ICU patients either have sepsis on admission to the ICU or develop sepsis during their stay in the ICU.

To better understand how to treat patients with sepsis, the body’s systemic response to serious infection, a review article in Anesthesiology provided the latest update on the care of critically ill patients with severe sepsis. The article also pointed to newer potential therapies that may change the way sepsis is managed in the future.

In our article, we looked closely at the host’s immune response during sepsis. It is likely that in the future, we will be able to semi-quantify the strength of a patient’s immune function and improve the way in which the host reacts to sepsis when compromised.” – Richard S. Hotchkiss M.D.

“Therapy to restore immune function could make a huge difference in improving survival in sepsis patients,” he said.

For more information, visit the Anesthesiology website at www.anesthesiology.org.


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