ACC、AHA2007围手术期心血管评估和非心脏手术护理指南PPT.ppt

ACC/AHA 2007 Guidelines on Perioperative CardiovascularEvaluation and Care for Noncardiac Surgery A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) J Am Coll Cardiol 2007;50 e159-e241 WRITING COMMITTEE MEMBERS Lee A. Fleisher, MD, FACC, FAHA, Chair Joshua A. Beckman, MD, FACC Kenneth A. Brown, MD, FACC, FAHA Hugh Calkins, MD, FACC, FAHA Elliott Chaikof, MD Kirsten E. Fleischmann, MD, MPH, FACC William K. Freeman, MD, FACC James B. Froehlich, MD, MPH, FACC Edward K. Kasper, MD, FACC Judy R. Kersten, MD, FACC Barbara Riegel, DNSc, RN, FAHA John F. Robb, MD, FACC ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery Class I Benefit Risk Procedure/ Treatment SHOULD be performed/ administered Class IIa Benefit RiskAdditional studies with focused objectives needed IT IS REASONABLE to perform procedure/administer treatment Class IIb Benefit ≥ RiskAdditional studies with broad objectives needed; Additional registry data would be helpful Procedure/Treatment MAY BE CONSIDERED Class III Risk ≥ BenefitNo additional studies needed Procedure/Treatment should NOT be performed/administered SINCE IT IS NOT HELPFUL AND MAY BE HARMFUL should is recommended is indicated is useful/effective/ beneficial is reasonable can be useful/effective/ beneficial is probably recommended or indicated may/might be considered may/might be reasonable usefulness/effectiveness is unknown /unclear/uncertain or not well established is not recommended is not indicated should not is not useful/effective/beneficial may be harmful Applying Classification of Recommendations and Level of Evidence Level A Multiple (3-5) population risk strata evaluated General consistency of direction and magnitude of effect Class I ? Recommen-dation that procedure or treatment is usef