11
Table 6. Surveillance and Management for Perioperative MI
Recommendations COR LOE
Measurement of troponin levels is recommended in the
setting of signs or symptoms suggestive of myocardial
ischemia or MI.
I A
Obtaining an ECG is recommended in the setting of
signs or symptoms suggestive of myocardial ischemia,
MI, or arrhythmia.
I B
e usefulness of postoperative screening with troponin
levels in patients at high risk for perioperative MI, but
without signs or symptoms suggestive of myocardial
ischemia or MI, is uncertain in the absence of established
risks and benefits of a defined management strateg y.
IIb B
e usefulness of postoperative screening with ECGs in
patients at high risk for perioperative MI, but without signs
or symptoms suggestive of myocardial ischemia, MI, or
arrhythmia, is uncertain in the absence of established risks
and benefits of a defined management strateg y.
IIb B
Routine postoperative screening with troponin levels in
unselected patients without signs or symptoms suggestive
of myocardial ischemia or MI is NOT useful for guiding
perioperative management.
III: No
Benefit
B
Table 5. Anesthetic Consideration and Intraoperative
Management (cont'd)
Recommendations COR LOE
Perioperative use of pulmonary artery catheters
e use of pulmonary artery catheterization may be
considered when underlying medical conditions that
significantly affect hemodynamics (i.e., HF, severe valvular
disease, combined shock states) cannot be corrected before
surgery.
IIb C
Routine use of pulmonary artery catheterization
in patients, even those with elevated risk, is NOT
recommended.
III: No
Benefit
A
