Assessment and management of the geriatric patient
- 1 April 2004
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 32 (4), S92-S105
- https://doi.org/10.1097/01.ccm.0000122069.56161.97
Abstract
To describe the potential critical care problems that arise as a result of aging and to identify some of the methods that may be used to minimize these problems. The population of the United States is aging. This is reflected in the age of our surgical patients. Aging is associated with myriad physiologic changes and an increased susceptibility to disease, all of which renders older patient more susceptible to the negative sequela of anesthetic and surgical stress. Minimizing the effects of aging begins preoperatively by assessing the impact of these changes on the individual patient. Once deficits are identified, efforts can be made to correct what is correctable preoperatively and to address what is not by designing an intra- and postoperative plan that limits additional stress to the compromised system. Although good data regarding optimal perioperative management of the elderly patient are presently lacking, awareness of the areas of potential vulnerability allows the anesthesiologist and surgeon to design their treatment plans with these limitations in mind. By identifying the limitations imposed by aging, critical care problems in elderly patients can be anticipated and addressed, and surgical outcomes can be improved.Keywords
This publication has 73 references indexed in Scilit:
- Aspiration Pneumonitis and Aspiration PneumoniaNew England Journal of Medicine, 2001
- Oxygen consumption in the early postinjury period: Use of continuous, on-line indirect calorimetryCritical Care Medicine, 2000
- Prolonged Overexpansion of Extracellular Water in Elderly Patients With SepsisArchives of Surgery, 1998
- Heart Failure with Normal Systolic Function: A Common Disorder in Older PeopleJournal of the American Geriatrics Society, 1995
- Influence of Age on Gastric Emptying in Healthy ChineseClinical Nuclear Medicine, 1994
- Effect of age, Helicobacter pylori infection, and gastritis with atrophy on serum gastrin and gastric acid secretion in healthy men.Gut, 1993
- Unrecognized myocardial infarction and hypertension: The Framingham StudyAmerican Heart Journal, 1985
- Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly.BMJ, 1983
- Community‐Acquired Bacteremia in the Elderly: Analysis of One Hundred Consecutive EpisodesJournal of the American Geriatrics Society, 1980
- Prediction of Creatinine Clearance from Serum CreatinineNephron, 1976