围手术期心血管评估和非心脏手术护理指南.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) Active Cardiac Conditions for Which the Patient Should Undergo Evaluation and Treatment Before Noncardiac Surgery Estimated Energy Requirements for Various Activities Cardiac Risk Stratification for Noncardiac Surgical Procedures Recommendations for Preoperative Noninvasive Evaluation of LV Function Class I (none) Class IIa It is reasonable for patients with dyspnea of unknown origin to undergo preoperative evaluation of LV function. (C) It is reasonable for patients with current or prior HF with worsening dyspnea or other change in clinical status to undergo preoperative evaluation of LV function if not performed within 12 months. (C) Class IIb Reassessment of LV function in clinically stable patients with previously documented cardiomyopathy is not well established. (C) Class III Routine perioperative evaluation of LV function in patients is not recommended. (B) Class I: Preoperative resting 12-lead ECG is recommended for pts with: At least 1 clinical risk factor* who are undergoing vascular surgical procedures. (B) Known CHD, peripheral arterial disease, or cerebrovascular disease who are undergoing intermediate-risk surgical procedures. (C) Class IIa: Preoperative resting 12-lead ECG is reasonable in persons with no clinical risk factors who are undergoing vascular surgical procedures. (B) Class IIb: Preoperative resting 12-lead ECG may be reasonable in patients with at least 1 clinical risk factor who are undergoing intermediate-risk operative procedures. (B) Class III: Preoperative and postoperative resting 12-lead ECGs are not indicated in asymptomatic persons undergoing low-risk surgical procedures. (B) Class I: Patients with active cardiac