Preoperative assessment of the immunocompromised patient
2011
In some surgical patients immunosuppression is easily apparent and directly
caused by known underlying disease or treatment. In others, although induced
by the underlying disease, immunosuppression may be less obvious.
Perioperative management of immunocompromised patient is mostly directed by
the fact that immunosuppression itself does not cause pathology, but does
leave the patient prone to infection. Immunodeficiency can be broadly
characterized as congenital (primary) or acquired (secondary). The majority
of immune deficiencies that are of interest to the anaesthetist are acquired.
They can be present both in children and adults, in a huge variety of
patients that are presented preoperatively. Most of them do not require
different than usual perioperative anaesthetic management. However, in some
of them specific aspects of treatment should be considered, such as HIV
infected, cancer, transplant patients, and those scheduled for organ
transplantation.
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