Improving perioperative outcome: time to update protocols

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The ideal aim of perioperative medicine is to provide complete organ protection without complications, with no failures to rescue and with total avoidance of postoperative disability and loss of independence. This implicitly means no unplanned readmission to hospital or unplanned admission to the ICU. Fundamental to the success of such strategies are the highest standards in perioperative medicine. Clinical excellence in this field requires extensive expertise in various domains of medicine that include the ability to critically appraise and integrate all sources of patient information, a talent for organisation, a large knowledge base and a desire for continuous learning and the ability to control outcomes. Busy clinicians too often neglect the last two issues. This editorial offers a short update of some relevant scientific investigations in high-risk patients having noncardiac surgery, which could be incorporated into daily practice to improve outcomes.
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