Medical Consultation on Surgical Services: An Annotated Bibliography
Authors: RICHARD GROSS
Journal: Annals of Internal Medicine (1981)

The Literature of Medicine1 October 1981Medical Consultation on Surgical Services: An Annotated BibliographyRICHARD GROSS, M.D., Sc.M. (Hyg.), WILLIAM KAMMERER, M.D.RICHARD GROSS, M.D., Sc.M. (Hyg.)Search for more papers by this author, WILLIAM KAMMERER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-4-523_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptConsultation on nonmedical patients is an important part of the role of general internists and subspecialists. Residency programs are increasingly providing separate rotations on general medical consultation services to specifically provide training in medical problems of patients on nonmedical services.The bibliography provides a literature base for physicians interested in this area of consultation. The references encompass medical problems that are not directly related to the primary reason for admission to the surgical service. Most citations focus on the assessment of the risk posed by medical problems for planned surgical procedures and on the interrelations between medical and surgical problems....General Cardiology ARRHYTHMIAS AND CONDUCTION ABNORMALTIES CONGESTIVE HEART FAILURE CORONARY ARTERY DISEASE DIGITALIZATION HYPERTENSION PROPRANOLOL TRAUMA VALVULAR HEART DISEASE Drugs: Perioperative Management Surgery in the Elderly Endocrinology DIABETES MELLITUS PHEOCHROMOCYTOMA THYROID Gastroenterology Hematology Infectious Disease Neurology Nutrition Pulmonary Medicine ASTHMA CHRONIC OBSTRUCTIVE PULMONARY DISEASE: PREOPERATIVE ASSESSMENT CHRONIC OBSTRUCTIVE PULMONARY DISEASE: PERIOPERATIVE MANAGEMENT POSTOPERATIVE PULMONARY MANAGEMENT PULMONARY RESECTION Nephrology; Fluid, Electrolyte, and Acid-Base Physiology Rheumatology Thromboembolism and Anticoagulation ANTICOAGULATION FAT EMBOLI THROMBOEMBOLISM Residency Training*1. CORMANBOLT LR eds. Symposium on medical evaluation of the preoperative patient. Med Clin North Am. 1979;63:1129-357. Comprehensively reviews preoperative evaluation of medical problems for each organ system. Additional chapters cover nutrition, estimating surgical risk, assessing healthy patients, emotional impact of surgery, and informed consent. Google Scholar*2. GOLDMAN L. Supraventricular tachyarrhythmias in hospitalized adults after surgery: clinical correlates in patients over 40 years of age after major noncardiac surgery. Chest. 1978;73:450-4. Development of supraventricular arrhythmias postoperatively was related to concurrent acute medical problems, both cardiac and noncardiac. All arrhythmias reverted promptly, but the underlying noncardiac disorder caused a 49% mortality. CrossrefMedlineGoogle Scholar3. KATZBIGGER RJ Cardiac arrhythmias during anesthesia and operation. Anesthesiology. 1970;33:193-213. Reviews mechanism, causes, and treatment of arrhythmias during anesthesia. Most arrhythmias are related to and require changes in anesthetic management rather than antiarrhythmiac drug therapy. CrossrefMedlineGoogle Scholar4. PASTOREYURCHAKJANISMURPHYZIR JPKJL. The risk of advanced heart block in surgical patients with right bundle branch block and left axis deviation. Circulation. 1978;57:677-80. The presence of right bundle branch block and left axis deviation does not impose a high risk of complete heart block during surgery, and temporary pacemakers are not needed in all patients. CrossrefMedlineGoogle Scholar5. SIMON A. Perioperative management of the pacemaker patient. Anesthesiology. 1977;46:127-31. Reviews management of patients with pacemakers during and after surgery, including preoperative evaluation and prevention of electrical interference with pacemaker function in the operating room. CrossrefMedlineGoogle Scholar6. VANDAMMCLEMORE LG. Circulatory arrest in patients with complete heart block during anesthesia and surgery. Ann Intern Med. 1957;47:518-32. In this study done before the pacemaker era, cardiac arrest occurred during surgery in one fourth of patients with complete heart block but mostly in patients with a history of Stokes-Adams attacks. All patients were resuscitated with drug therapy. LinkGoogle Scholar7. VANIKDAVIS PH. Cardiac arrhythmias during halothane anesthesia. Anesth Analg (Cleve). 1968;47:299-307. The most frequent arrhythmias in patients undergoing general anesthesia were nodal rhythm, premature ventricular contractions, and sinus bradycardia; most were transient. Most patients received halothane, but other anesthetic agents were used. See also References 1 and 13. MedlineGoogle Scholar See References 1, 13*, and 15. Google Scholar8. BONCHECKOLINGER LG. Intra-aortic balloon counterpulsation for cardiac support during noncardiac operations. J Thorac Cardiovasc Surg. 1979;78:147-9. Report of three cases and brief literature review on use of intra-aortic balloon pump for high-risk patients undergoing noncardiac surgery. Notes disagreement about indications for use of pump in general surgery. CrossrefMedlineGoogle Scholar9. CRAWFORDMORRISHOWELLFLYNNMOORHEAD EGJWD. Operative risk in patients with previous coronary artery bypass. Ann Thorac Surg. 1978;26:215-21. Noncardiac surgery done on 358 patients after coronary artery bypass grafting was well tolerated with a total mortality of 1.1% (none cardiac). Most cardiac complications occurred in patients operated on within 1 month of bypass. CrossrefMedlineGoogle Scholar10. DIXONFUCHSEBERT SJP. Changes in serum creatine phosphokinase activity following thoracic, cardiac, and abdominal operations. Arch Surg. 1971;103:66-8. Total creatine phosphokinase values rise postoperatively in most surgical patients with a peak at 24 to 48 hours. The magnitude and pattern of rise do not separate patients with and without postoperative myocardial infarction occurring before the third postoperative day. Creatine phosphokinase isoenzymes were not measured. CrossrefMedlineGoogle Scholar*11. ERLIKVALEROBIRKHANGERSH DAJI. Prostatic surgery and the cardiovascular patient. Br J Urol. 1968;40:53-61. Patients with stable cardiovascular disease underwent prostate resection with the same 1% mortality as patients without heart disease. CrossrefMedlineGoogle Scholar*12. GOLDMANCALDERANUSSBAUM LDS. Multifactorial index of cardiac risk in noncardiac surgical procedures. N. Engl J Med. 1977;297:845-50. Report of a prospective, multivariate study that found that major cardiac risk factors were age, aortic stenosis, infarction, third heart sound gallop or jugular venous distention, arrhythmia, type of operation, and certain other organ system disease. Already a classic article. CrossrefMedlineGoogle Scholar*13. GOLDMANCALDERASOUTHWICK LDF. Cardiac risk factors and complications in non-cardiac surgery. Medicine (Baltimore). 1978;57:357-70. Detailed analysis of the best prospective study of cardiac risk factors (12) accompanied by a comprehensive literature review. Systematically covers complications such as heart block and congestive failure, in addition to cardiac death. CrossrefMedlineGoogle Scholar14. MAHARSTEENTINKERVLIETSTRASMITHPLUTH LPJRHJ. Perioperative myocardial infarction in patients with coronary artery disease with and without aorta-coronary artery bypass grafts. J Thorac Cardiovasc Surg. 1978;76:533-7. Retrospective series comparing patients with and without coronary bypass grafts before noncardiac surgery. The three patients with postoperative myocardial infarction had triple-vessel disease. CrossrefMedlineGoogle Scholar*15. SKINNERPEARCE JM. Surgical risk in the cardiac patient. J Chronic Dis. 1964;17:57-72. Extensive retrospective series covering operative risks of hypertension, congestive failure, and ischemic and valvular heart diseases. CrossrefMedlineGoogle Scholar16. STEENTINKERTARHAN PJS. Myocardial reinfarction after anesthesia and surgery. JAMA. 1978;239:2566-70. Risk of reinfarction was highest for surgery done within 6 months of myocardial infarction. Additional risk factors were abdominal or thoracic operation and duration of anesthesia. CrossrefMedlineGoogle Scholar17. TARHANMOFFITTTAYLORGIULIANI SEWE. Myocardial infarction after general anesthesia. JAMA. 1972;220:1451-4. Risk of recurrent myocardial infarction during surgery is highest within 3 months of a previous infarction and remains substantially increased between 3 and 6 months. Reinfarction occurs throughout the first week postoperatively, with peak frequency on the third day. See also References 1, 49, and 50. CrossrefMedlineGoogle Scholar18. DEUTSCHDALEN SJ. Indications for prophylactic digitalization. Anesthesiology. 1969;30:648-56. Indications and use of digitalis perioperatively are reviewed, with brief discussion of effect of anesthesia on myocardial function and its modification by digitalis compounds. Most comprehensive review available; certain aspects are dated (see Reference 1 for update). See also References 1, 2 and 13. CrossrefMedlineGoogle Scholar19. GALCOOPERMAN TL. Hypertension in the immediate postoperative period. Br J Anaesth. 1975;47:70-4. Most patients with postoperative hypertension were hypertensive preoperatively. Complications were confined to the 20% of patients whose postoperative blood pressure elevation lasted 3 or more hours. CrossrefMedlineGoogle Scholar*20. GOLDMANCALDERA LD. Risk of general anesthesia and elective operation in the hypertensive patient. Anesthesiology. 1979;50:285-92. Patients with mild to moderate hypertension (diastolic pressure less than 110) did not have an increased risk of cardiac, renal, or central nervous system complications. Untreated hypertensive patients had larger intraoperative blood pressure decreases, but not to the extent that specific therapy was needed. CrossrefMedlineGoogle Scholar21. PRYS-ROBERTS C. Hypertension and anesthesia—fifty years on. Anesthesiology. 1979;50:281-4. Editorial. Author concluded that patients with mild to moderate untreated hypertension are not at increased operative risk; patients with severe (diastolic pressure greater than 110) hypertension may have a higher prevalence of relative hypotension and myocardial ischemia. CrossrefMedlineGoogle Scholar22. PRYS-ROBERTSMELOCHEFOEX CRP. Studies of anesthesia in relation to hypertension: 1. Cardiovascular responses of treated and untreated patients. Br J Anaesth. 1971;43:122-37. Untreated or partially treated hypertension was related to severe hypotension and electrocardiographic evidence of myocardial ischemia during anesthesia in a small (n = 29) series. See also References 1, 13, 15, and 33. CrossrefMedlineGoogle Scholar23. GOLDMAN L. Noncardiac surgery in patients receiving propranolol. Arch Intern Med. 1981;141:193-6. Perioperative management of propranolol is outlined according to the very limited data available. Oral propranolol should be continued to the morning of surgery. Indications for routine postoperative use of intravenous propranolol are uncertain. CrossrefMedlineGoogle Scholar*24. CHEITLINABBOTT MJ. The internist's role in the recognition and management of cardiovascular trauma. Med Clin North Am. 1979;63:201-21. Detailed, comprehensive discussion of the diagnosis and management of cardiac complications of trauma. An approach to the acutely injured patient and common sequelae are emphasized. CrossrefMedlineGoogle Scholar See References 1, 13*, 15, 83, and 84. Google Scholar See References 1, 18, 20, 21, 23, 29, 83, 84. Google Scholar25. DEL GUERCIOCOHN LJ. Monitoring operative risk in the elderly. JAMA. 1980;243:1350-5. Invasive measurement of left ventricular function and oxygen transport may be a better predictor of operative risk in the elderly than American Society of Anesthesiology classification. CrossrefMedlineGoogle Scholar*26. DJOKOVICHEDLEY-WHYTE JJ. Prediction of outcome of surgery and anesthesia in patients over 80. JAMA. 1979;242:2301-6. Surgery done in patients over age 80 had a 6% hospital mortality. The commonest causes of deaths were myocardial infarction, mesenteric infarction, and infection. CrossrefMedlineGoogle Scholar27. O'DONNELLDARLINGLINTON TRR. Is 80 years too old for aneurysmectomy? Arch Surg. 1976;111:1250-7. Patients over age 80 can undergo elective surgery for abdominal aortic aneurysms with a 5% mortality, which is similar to the mortality for younger patients. CrossrefMedlineGoogle Scholar28. ZIFFRENHARTFORD SC. Comparative mortality for various surgical operations in older versus younger age groups. J Am Geriatr Soc. 1972;20:485-9. Most recent study providing mortality figures for operation in the elderly and comparative data for younger patients. See also references 13 and 59. CrossrefMedlineGoogle Scholar29. PLUMPTONBESSERCOLE FGP. Corticosteroid treatment and surgery: 1. An investigation of the indication for steroid cover. 2. The management of steroid cover. Anaesthesia. 1969;24:3-11, 12-18. The response of the adrenal glands to surgical stress is described and steroid coverage regimens evaluated. See also Reference 1. CrossrefMedlineGoogle Scholar*30. GALLOWAYSHUMAN JC. Diabetes and surgery: a study of 667 cases. Am J Med. 1963;34:177-91. The largest series and most complete description of problems in managing diabetes during surgery. CrossrefMedlineGoogle Scholar*31. MOLITCHREICHLIN MS. The care of the diabetic patient during emergency surgery and postoperatively. Orthop Clin North Am. 1978;9:811-24. Well-organized review of perioperative diabetic management including preoperative evaluation, diet, fluids, and insulin requirements. CrossrefMedlineGoogle Scholar32. TAITELMANREECEBESSMAN UEA. Insulin in the management of the diabetic surgical patient: continuous intravenous infusion vs. subcutaneous administration. JAMA. 1977;237:658-60. Continuous low-dose insulin resulted in tighter glucose control but more "hypoglycemic" glucose values during surgery compared to single-dose NPH insulin preoperatively. See also Reference 1. CrossrefMedlineGoogle Scholar33. ENGLEMAN K. Pheochromocytoma. Clin Endocrinol Metab. 1977;6:769-97. Comprehensive review of pheochromocytoma including perioperative management. Intravascular volume replacement is an important part of preoperative preparation. CrossrefMedlineGoogle Scholar See Reference 1. Google Scholar*34. DYKESWALZER MS. Preoperative and postoperative hepatic dysfunction. Surg Gynecol Obstet. 1967;124:747-51. Serum aminotransferase levels increased in patients with unsuspected hepatitis undergoing general anesthesia. MedlineGoogle Scholar*35. HARVILLESUMMERSKILL DW. Surgery in acute hepatitis: causes and effects. JAMA. 1963;184:257-61. Patients with viral hepatitis undergoing surgery had a high frequency of complications. The major problem with a few cases of drug-induced hepatitis was prolonged jaundice. CrossrefMedlineGoogle Scholar*36. LAMONTISSELBACHER JK. Postoperative jaundice. N Engl J Med. 1973;288:305-7. A logical approach is presented to the differential diagnosis of this common clinical problem. CrossrefMedlineGoogle Scholar*37. PETERSONCOLLINSWILSON LJR. Acute pancreatitis occurring after operation. Surg Gynecol Obstet. 1968;127:23-8. Postoperative pancreatitis is usually seen after biliary or other upper abdominal surgery. Mortality was high (36%). Initial signs are nonspecific (hypotension, oliguria, and jaundice). MedlineGoogle Scholar*38. PRIEBESKILLMANBUSHNELLLONGSILEN HJLPW. Antacid versus Cimetidine in preventing acute gastrointestinal bleeding: a randomized trial in 75 critically ill patients. N Engl J Med. 1980;302:426-30. An intensive antacid regimen is superior to Cimetidine in preventing upper gastrointestinal bleeding in critically ill patients.See also Reference 75. CrossrefMedlineGoogle Scholar39. BOXERBROWNELLMAN MJL. Thromboembolic risk of postsplenectomy thrombocytosis. Arch Surg. 1978;113:808-9. Retrospective study of 318 patients without myeloproliferative disorders who underwent splenectomy showed no substantial increase in the frequency of thromboembolism, although thrombocytosis developed in 75% of the patients. CrossrefMedlineGoogle Scholar*40. KOWALYSHYNPRAGERYOUNG TDJ. A review of the present status of preoperative hemoglobin requirements. Anesth Analg (Cleve). 1972;51:75-9. Literature review did not uncover empirical data supporting an absolute minimum hematocrit value needed for anesthesia. Survey of anesthesia department practices is presented. CrossrefMedlineGoogle Scholar41. SEARLE J. Anesthesia in sickle cell states. Anesthesia. 1973;28:48-58. The risk of general anesthesia is increased but not prohibitive in patients with sickle hemoglobinopathies (11 deaths in 144 patients). The significance of the increased anesthesia risk of sickle trait is questioned. CrossrefMedlineGoogle Scholar42. SEARS D. The morbidity of sickle cell trait: a review of the literature. Am J Med. 1978;64:1021-36. Findings of extensive literature review did not support an increased surgical risk in patients with sickle cell trait. CrossrefMedlineGoogle Scholar43. WASSERMANGILBERT LH. Surgery in polycythemia vera. N Engl J Med. 1963;269:1226-30. Risk of surgery is greater in untreated patients with polycythemia vera. Fewer complications occurred in untreated patients whose hematocrits were acutely lowered preoperatively, but the risk was still greater than in patients receiving chronic therapy. CrossrefMedlineGoogle Scholar*44. ALTEMEIERCULBERTSONFULLENSHOOK WWWC. Intra-abdominal abscesses. Am J Surg. 1973;125:70-9. Problems encountered in diagnosing intra-abdominal abscesses are discussed on the basis of data from the author's series of 500 cases. CrossrefMedlineGoogle Scholar*45. FINEGOLDBARTLETTCHOW SJA. Management of anaerobic infections. Ann Intern Med. 1975;83:375-89. Reviews antibiotic selection for anaerobic infections after abdominal-pelvic surgery and trauma, with extensive references. LinkGoogle Scholar*46. JACOBYMANDELLWEINSTEIN ILL. The chemoprophylaxis of infection: a brief review of recent studies. Med Clin North Am. 1978;62:1083-98. Concise review of recent studies with recommendations for current usage of prophylatic antibiotics in surgery (see also Reference 1). CrossrefMedlineGoogle Scholar*47. KAPLANANTHONYBISNO EBA. Prevention of bacterial endocarditis. Circulation. 1977;56:139A-43A. Current recommendations for bacterial endocarditis prophylaxis during procedures and surgery. See also References 1, 77, and 94. MedlineGoogle Scholar48. CARNEYSTEWARTDEPINTOMUCHAROBERTS WWDSB. Carotid bruit as a factor in aortoiliac reconstruction. Surgery. 1977:81:567-70. Asymptomatic carotid bruits do not imply an increased risk for postoperative stroke. MedlineGoogle Scholar49. ENNIXLAWRIEMORRIS CGG. Improved results of carotid endarterectomy in patients with symptomatic coronary disease: an analysis of 1, 546 consecutive carotid operations. Stroke. 1979;10:122-5. Patients with symptomatic coronary artery disease had lower mortality and fewer cardiac complications during carotid endarterectomy if bypass grafting was done first. CrossrefMedlineGoogle Scholar50. KNAPPTOPKINSARTUSIO RMJ. The cerebrovascular accident and coronary occlusion in anesthesia. JAMA. 1962;182:332-4. Cerebrovascular accidents after general surgery are rare even in patients who have had strokes. CrossrefMedlineGoogle Scholar*51. MESULAMGESCHWIND MN. Disordered mental states in the postoperative period. Urol Clin North Am. 1976;3:199-215. Well-organized discussion of the differential diagnosis of and clinical approach to altered mental status after surgery. See also Reference 1*. CrossrefMedlineGoogle Scholar52. BLACKBURNBISTRIANMAINISCHLAMMSMITH GBBHM. Nutritional and metabolic assessment of the hospitalized patient. J Parent Ent Nutr. 1977;1:11-22. Definitive article describing anthropometric techniques, creatinine height index, and metabolic variables (serum albumin and transferrin, total lymphocyte count, delayed skin hypersensitivity reactions). Also describes and correlates techniques for nitrogen balance and caloric intake requirements. CrossrefMedlineGoogle Scholar*53. BLACKBURNMAINIPIERCE GBE. Nutrition in the critically ill patient. Anesthesiology. 1977;47:181-94. Extended review of metabolic response to injury, nutritional assessment techniques, and strategies for perioperative nutritional support. Discusses basic physiologic concepts of hyperalimentation and describes specific problems in the critically ill patient. CrossrefMedlineGoogle Scholar54. FLEMINGMCGILLHOFFMANNELSON CDHR. Total parenteral nutrition. Mayo Clin Proc. 1976;51:187-99. Detailed review of total parenteral nutrition including basic aims and indications, nutritional requirements, types of parenteral solutions, catheter care, and patient monitoring. See also Reference 70*. MedlineGoogle Scholar55. OHPATTERSON SR. Surgery and corticosteroid dependent asthmatics. J Allergy Clin Immunol. 1974;53:345-51. Steroid-dependent asthmatic patients can undergo general surgery with an acceptable risk. Perioperative management is outlined and the experience with a small series described. CrossrefMedlineGoogle Scholar56. VALENTINE M. The asthmatic patient as a surgical risk. Surg Clin North Am. 1970;50:631-5. Clinical discussion of managing the asthmatic patient during surgery. See also References 77 and 85. CrossrefMedlineGoogle Scholar57. LATIMERDICKMANDAYGUNNSCHMIDT RMWMC. Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis. Am J Surg. 1971;122:622-32. Postoperative atelectasis occurred after upper abdominal surgery in all patients with abnormal preoperative values for forced expiratory volume in 1 second or forced vital capacity. The major pulmonary function change postoperatively was restrictive and took as long as a week to return to normal. CrossrefMedlineGoogle Scholar58. STEINKOOTASIMONFRANK MGMH. Pulmonary evaluation of surgical patients. JAMA. 1962;181:765-70. Postoperative pulmonary complications occurred almost exclusively in patients with abnormal spirometric findings. Age and location of incision were other risk factors. CrossrefMedlineGoogle Scholar*59. TARHANMOFFITTSESSLERDOUGLASTAYLOR SEAWW. Risk of anesthesia and surgery in patients with chronic bronchitis and chronic obstructive pulmonary disease. Surgery. 1973;74:720-6. The mortality rate was increased for men with clinically moderate to severe chronic obstructive lung disease. Nonpulmonary risk factors contributed to the operative risk. Preoperative preparation decreased the number of complications but not mortality. MedlineGoogle Scholar*60. TISI G. Preoperative evaluation of pulmonary function: validity, indications, and benefits. Am Rev Respir Dis. 1979;119:293-310. Comprehensive review of perioperative pulmonary problems includes pathophysiology, risk factors, and prophylactic treatment. MedlineGoogle Scholar61. WILLIAMSBRENOWITZ CJ. "Prohibitive" lung function and major surgical procedures. Am J Surg. 1976,132:763-6. Surgery was done on 16 patients having "prohibitive" pulmonary function according to literature criteria. There were one death and three major pulmonary complications. Prohibitive lung function by itself does not preclude consideration for needed surgery. See also References 1 and 64. CrossrefMedlineGoogle Scholar*62. BARTLETTGAZZANIGAGERAGHTY RAT. Respiratory maneuvers to prevent postoperative pulmonary complications: a critical review. JAMA. 1973;224:1017-21. Authors conclude that effectiveness has been shown for devices producing sustained inspiration (incentive spirometer) but not for intermittent positive-pressure breathing. CrossrefMedlineGoogle Scholar*63. DOHIGOLD SM. Comparison of two methods of postoperative respiratory care. Chest. 1978;73:592-5. A randomized trial found that incentive spirometry was superior (p < 0.051) to intermittent positive-pressure breathing in preventing postoperative pulmonary complications. CrossrefMedlineGoogle Scholar64. STEINCASSARA ME. Preoperative pulmonary evaluation and therapy for surgery patients. JAMA. 1970;211:787-90. Patients receiving preoperative pulmonary therapy had fewer complications in a small randomized trial. See also References 59 and 60.* CrossrefMedlineGoogle Scholar*65. FEELEYHEDLEY-WHYTE TJ. Weaning from controlled ventilation and supplemental oxygen. N Engl J Med. 1975;292:903-6. Review of criteria, methods, complications, and failures of weaning, with pertinent references. CrossrefMedlineGoogle Scholar66. HEENANDOWNSDOUGLASRUIZJUMPER TJMBL. Intermittent mandatory ventilation: is synchronization important? Chest. 1980;77:598-602. Nonsynchronized intermittent mandatory ventilation did not impair cardiac or pulmonary function in a laboratory study. CrossrefMedlineGoogle Scholar67. LIGHTGEORGE RR. Incidence and significance of pleural effusions after abdominal surgery. Chest. 1976;69:621-5. In this series no patient with a pleural effusion had a pulmonary embolus; one patient had infected fluid. Pleural effusions develop in about half of patients after abdominal surgery. See also Reference 77*. CrossrefMedlineGoogle Scholar68. BOUSHYHELGASONBILLIGGYORKY SADF. Clinical, physiologic, and morphologic examination of the lung in patients with bronchogenic carcinoma and the relation of the findings to postoperative deaths. Am Rev Respir Dis. 1970;101:685-95. Most patients undergoing resection of a lung carcinoma have evidence of chronic obstructive lung disease on either clinical examination, pulmonary function testing, or pathologic specimens. Pulmonary function tests were the best predictors of patients who died. MedlineGoogle Scholar*69. BOYSENBLOCKOLSENMOULDERHARRISRAWITSCHER PAGPJR. Prospective evaluation for pneumonectomy using the 99mtechnetium quantitative perfusion lung scan. Chest. 1977;72:422-5. Mortality for patients with borderline pulmonary function who undergo pneumonectomy can be 15% if quantitative lung scanning predicts a postoperative forced expiratory volume in 1 second greater than 800 mL. See also Reference 60. CrossrefMedlineGoogle Scholar*70. ABELBECKABBOTTRYANBARNETTFISCHER RCWJGJ. Improved survival from acute renal failure after treatment with intravenous essential 1-amino acids and glucose: results of a prospective, double-blind study. N Engl J Med. 1973;288:695-8. Survival from acute renal failure was improved by hyperalimentation with essential amino acids in a randomized trial. CrossrefMedlineGoogle Scholar*71. BAEKMAKABALISHOEMAKER SGW. Clinical determinants of survival from postoperative renal failure. Surg Gynecol Obstet. 1975;140:685-9. Mortality of postoperative renal failure was 62%; sepsis was an important contributor to mortality. The average duration of renal failure in survivors was 11 days. MedlineGoogle Scholar72. BROWNOGGSCAMEROY CCJ. High dose furosemide in acute renal failure: a controlled study. Clin Nephrol. 1981;15:90-6. High-dose furosemide did not affect the duration of renal failure, number of dialyses, or mortality in a randomized trial of patients with acute renal failure after surgery or trauma. MedlineGoogle Scholar*73. CONGER J. A controlled evaluation of prophylactic dialysis in post-traumatic acute renal failure. J Trauma. 1975;15:1056-63. Survival was improved by earlier and more intensive dialysis in a small, well-controlled comparative study. There were fewer complications due to infection in the group receiving intensive dialysis. CrossrefMedlineGoogle Scholar*74. DANIELSON R. Differential diagnosis and treatment of oliguria in post-traumatic and postoperative patients. Surg Clin North Am. 1975;55:697-712. An approach is outlined to the differential diagnosis and treatment of acute renal failure in surgical patient. Although somewhat basic, this well-referenced review is the best available overview of the subject. CrossrefMedlineGoogle Scholar75. DAWSON J. The incidence of postoperative renal failure in obstructive jaundice. Br J Surg. 1965;52:663-5. The incidence of postoperative renal failure is increased among patients with jaundice and a bilirubin value above 20 mg/dL. CrossrefMedlineGoogle Scholar76. MERINOBUSELMEIERKJELLSTRAND GTC. Postoperative chronic renal failure: a new syndrome? Ann Surg. 1975;182:37-44. The prevalence of chronic renal failure after postsurgical acute tubular necrosis is much higher than previously thought. Factors increasing the risk are age above 60, nephrotoxic antibiotics, and anesthetics. CrossrefMedlineGoogle Scholar77. POLKSHIELDS HC. Remote organ failure: a valid sign of occult intra-abdominal infection. Surgery. 1977;81:310-3. Acute renal and respiratory failure may be the presenting signs of occult intra-abdominal infection. MedlineGoogle Scholar*78. RANDALL H. Fluid, electrolyte, and acid-base balance. Surg Clin N Am. 1976;56:1019-58. Concise review discussing the approach to electrolyte and acid-base problems in surgical patients. CrossrefMedlineGoogle Scholar79. SHINMACKENZIEMCASLANHELRICHCOWLEY BCCMR. Postoperative renal failure in trauma patients. Anesthesiology. 1979;51:218-21. Aggressive monitoring and therapy of volume depletion did not prevent renal failure in a comparative study. Patients in whom renal failure developed who were aggressively managed were less likely be oliguric and had a lower mortality. CrossrefMedlineGoogle Scholar80. TZAMALOUKASGARELLACHAZAN ASJ. Peritoneal dialysis for acute renal failure after major abdominal surgery. Arch Surg. 1973;106:639-43. Peritoneal dialysis was safe and effective in correcting metabolic abnormalities when done after major abdominal surgey in a small series of patients. The only complication of dialysis was wound dehiscence in one patient. See also Reference 1. CrossrefMedlineGoogle Scholar*81. COVENTRYBACKENBAUGHNOLANILSTRUP MRDD. 2,012 total hip arthroplasties: a study of postoperative course and early complications. J Bone Joint Surg (Am). 1974;56-A: 273-84. Medical complications occurred in one-fourth of patients. The commonest problems were urinary tract infection, acute renal failure, pneumonitis, and atelectasis. Hospital mortality was 0.4%. CrossrefMedlineGoogle Scholar*82. HABERMANFEINSTEIN EP. Total hip replacement arthroplasty in arthritic conditions of the hip joint. Semin Arthritis Rheum. 1978;7:189-231 Indications for and history of five surgical procedures for hip reconstruction are reviewed. Preoperative preparation and postoperative management should be geared to meet common medical complications. See also References 46, 85, 90 to 93, and 96. CrossrefMedlineGoogle Scholar83. KATHOLINOLANMCGUIRE RSL. The management of anticoagulation during noncardiac operations in patients with prosthetic heart valves: a prospective study. Am Heart J. 1978;96;163-5. Anticoagulation was discontinued temporarily for surgery in 45 patients with artificial valves. There were three bleeding episodes and no instances of embolization. CrossrefMedlineGoogle Scholar84. TINKERTARHAN JS. Discontinuing anticoagulant therapy in surgical patients with cardiac valve prostheses. JAMA. 1978;239:738-9. There is minimal risk to stopping anticoagulation for 2 to 10 days perioperatively in patients with valve prostheses. See also Reference 1. CrossrefMedlineGoogle Scholar85. OHMITAL WM. Fat embolism: current concepts of pathogenesis, diagnosis, and treatment. Orthop Clin North Am. 1978;9:769-79. Documented fat embolization causes a mortality of 15%. The clinical and laboratory findings are variable; a high index of suspicion is needed, especially in patients with trauma. Respiratory care and corticosteroids are advocated. CrossrefMedlineGoogle Scholar*86. BELLMEEK WA. Guidelines for the use of thrombolytic agents. N Engl J Med. 1979;301:1266-70. Review of indications for and clinical use of thrombolytic agents. Surgical procedures within 10 days are considered a contraindication to use of these agents. CrossrefMedlineGoogle Scholar*87. COON W. Epidemiology of venous thromboembolism. Ann Surg. 1977;186:149-63. Comprehensive review of venous thrombosis: incidence and prevalence, risk factors, and sequelae. CrossrefMedlineGoogle Scholar88. COTTONROBERTS LV. The prevention of deep vein thrombosis with particular reference to mechanical methods of prevention. Surgery. 1977;81:228-35. Mechanical measures designed to counteract venous stasis after surgery appear to be as effective as minidose heparin prophylaxis for thromboembolic disease. MedlineGoogle Scholar89. CRAWFORDDUMBADZERATLEDGEMULVANEYWENDEL EIHWR. Deep venous thrombosis following transurethral resection of the prostate: diagnosis by phleborheography. J Urol. 1978;120:438-41. A 4.6% incidence of venous thrombosis was found by phleborheography after transurethral prostate surgery. CrossrefMedlineGoogle Scholar90. HARRISSALZMANATHANASOULISWALTMANDESANCTIS WECAR. Aspirin prophylaxis of venous thromboembolism after total hip replacement. N Engl J Med. 1977;297:1246-9. Aspirin prevents venous thrombosis after total hip replacement in men but not women. CrossrefMedlineGoogle Scholar*91. Prevention of fatal postoperative pulmonary embolism by low doses of heparin. Lancet 1975;2:45-51. Prophylactic preoperative low-dose heparin reduced deaths due to pulmonary emboli and deep vein thrombosis in a large randomized trial. MedlineGoogle Scholar92. MCKENNABACHMANNKAUSHALGALANTE RFSJ. Thromboembolic disease in patients undergoing total knee transplant. J Bone Joint Surg (Am). 1976;58A:928-32. Phlebothrombosis occurs frequently after total knee replacement, but not as frequently as after hip surgery. CrossrefGoogle Scholar*93. MOSER K. Pulmonary embolism. Am Rev Respir Dis. 1977;115:829-52. Review covering diagnosis, therapy, and prophylaxis of pulmonary embolism. MedlineGoogle Scholar94. MURRAYELLISBLUMENTHALSOS HGDT. Fever and pulmonary thromboembolism. Am J Med. 1979;67:232-5. High fever and leukocytosis may occur with pulmonary embolism by stocking, dynamic compression, and anticoagulants. CrossrefMedlineGoogle Scholar97. WILLIAMSBRITTEADESSHERMAN JLTR. Pulmonary embolism after amputation of the lower extremity. Surg Gynecol Obstet. 1975;140:246-8. Patients undergoing amputation had a high incidence of pulmonary emboli proven by angiography or autopsy. See also References 1 and 67*. MedlineGoogle Scholar98. RUDDSIEGLERBYYNY PMR. Perioperative diabetic embolism. Fever may exceed 39 °C and persist for as long as a week. Google Scholar95. NEGUSFRIEDGOODCOXPEELWELLS DASAB. Ultra-low dose intravenous heparin in the prevention of postoperative deep-vein thrombosis. Lancet. 1980;1:891-4. A constant infusion of ultra-low dose heparin (1 IU/kg · h) prevented thromboembolic events in a small, randomized trial. CrossrefMedlineGoogle Scholar*96. SCHOLZJONESSABISTON PRD. Prophylaxis of thromboembolism. Adv Surg. 1979;13:115-43. A review of the literature on prophylaxis of thrombo-consultation: a plea for improved training. J Med Educ. 1978;53:590-6. Review of medical consultations on diabetic surgical patients showed marked differences in recommendations compared with literature-derived standards of care and variable follow-up by consultants. Consultation resulted in increased use of tests, but diabetic control was highly variable. MedlineGoogle Scholar99. MOOREKAMMERERMCGLYNNTRAUTLEINBURNSIDE RWTJJ. Consultations in internal medicine: a training program resource. J Med Educ. 1977;52:323-7. Referrals to a general medical consultation service were for common medical problems complicating surgical illness. One half of university consultation services had only a service and no teaching function. MedlineGoogle Scholar100. PERLMANKRUSKALLROSENZWEIGKAUFMAN LMDJ. Process and outcome in medical consultations: evaluation on a pulmonary service. Postgrad Med. 1975;57:111-5. The major reasons for pulmonary consultations not affecting the outcome of care were untreatable disease (usually neoplasia), diagnostic errors, and failure of the referring physician to follow the consultant's recommendations. See also Reference 1. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: RICHARD GROSS, M.D., Sc.M. (Hyg.); WILLIAM KAMMERER, M.D.Affiliations: Baltimore, Maryland; and Hershey, Pennsylvania▸From the Division of General Internal Medicine, Baltimore City Hospitals and The Johns Hopkins University School of Medicine, Baltimore, Maryland; and The Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania.▸Faculty contributing to the bibliography were P. Turer, G. Briefel, H. Tucker, D. Kern, and J. Stuckey (Baltimore City Hospitals), and J. Trautlein, T. McGlynn, D. Lookingbill, J. Burnside, J. Luderer, L. Grossman, K. Tantum, R. Gordon, and J. Woodcock, (Milton S. Hershey Medical Center). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPerioperative consultation: The science and the artPreoperative evaluationCorrection: Annotated Bibliography on Consultation 1 October 1981Volume 95, Issue 4Page: 523-529KeywordsHospital medicineLibrariesResidencySub-specialty care ePublished: 1 December 2008 Issue Published: 1 October 1981 Copyright & Permissions© 1981 American College of PhysiciansPDF downloadLoading ...