Perioperative Management of Chronic Pharmacotherapy in Cardiac Surgery: Literature Review and Recommendations
DOI:
https://doi.org/10.51481/amc.v67i4.1477Keywords:
Perioperative care, cardiac surgery, pharmacology, coronary artery bypass, extracorporeal circulation, cardiopulmonary bypassAbstract
Optimization of preoperative pharmacological therapy in cardiac surgery is essential to reduce perioperative complications and improve clinical outcomes. Various chronically used medications, such as angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulants, antiplatelets, beta-blockers, diuretics, and oral hypoglycemic agents, have significant implications in the context of cardiac surgery, particularly due to their interaction with cardiopulmonary bypass. These drugs may be associated with adverse events such as acute kidney injury, vasoplegic syndrome, postoperative bleeding, and multiorgan dysfunction, highlighting the importance of careful management. The objective of this review is to examine the most recent evidence on the perioperative management of these drugs and to highlight key recommendations based on the best available. Although there is no universal protocol, the approach should be multidisciplinary, tailored to the patient’s clinical characteristics, type of surgery, and comorbidities. Implementing appropriate strategies can mitigate complications and improve surgical outcomes in this high-risk population.
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