Guidelines to the Practice of Anesthesia: Revised edition 2011.

The Guidelines to the Practice of Anesthesia Revised Edition 2011 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. This allows for improved archiving and online access to complement the printed version-a new offering for CAS members and Journal subscribers. The Guidelines to the Practice of Anesthesia Revised Edition 2011 supersedes all previously published versions of this document. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.

Guidelines to the Practice of Anesthesia Revised Edition 2010.

OVERVIEW: The Guidelines to the Practice of Anesthesia Revised Edition 2010 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. This allows for improved archiving and online access to complement the printed version-a new offering for CAS members and Journal subscribers. The Guidelines to the Practice of Anesthesia Revised Edition 2010 supersedes all previously published versions of this document. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.

Protect the heart in the intensive care unit--but how?

The heart plays a pivotal role in determining the oxygen supply to the body. As a result of its high oxygen extraction ratio, the myocardium must function efficiently to supply itself with oxygen. In the context of the ICU, the efficient functioning of the myocardium is confounded by a number of pathologic processes that may interfere with its oxygen supply or increase its oxygen demand. Conventional drug treatment of acute myocardial decompensation tends to increase myocardial oxygen demand. The myocardium may potentially be "protected" by treatment modalities that favorably alter the oxygen supply to demand ratio. Newer methods of protecting the heart may involve improving the coordination of myocardial contraction, using novel inotropic agents, supporting the myocardium metabolically, administrating blood products more conservatively, favorably altering the immune response, and using mechanical support devices. Myocardial protection may be improved by better use and understanding of monitors of myocardial performance.