MORTALITY REDUCTION IN CARDIAC SURGERY (RESULTS OF THE FIRST INTERNATIONAL CONSENSUS CONFERENCE)

Every year more than a million of patients undergo cardiac surgery which is characterized by a significant mortality. The purpose of this article is to familiarize our readers with the results of the 1st International Consensus Conference published in Acta Anaesthesiol. Scand. in 2011, devoted to detection of interventions/manipulations increasing or reducing perioperative mortality basing on randomized evidences. Of the 17 major topics with mortality effect, seven were subsequently excluded after further evaluation. The following was recognized as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic β-blockade, early aspirin therapy, the use of pre-operative intra-aortic balloon counterpulsation, and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence. Conclusions: The further study is required for the investigation and evaluation of the above interventions.

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