Endothelial dysfunction in the peri-operative setting

Abstract

To provide a brief synopsis of endothelial (dys)function. To explore the pathophysiology of endothelial dysfunction in the perioperative period. To explore strategies for modulation of endothelial function. While peri-operative macrovascular events (e.g. myocardial infarction, stroke, etc) are readily evident, their absolute incidence remains relatively low. In contrast, microvascular dysfunction and its role in peri-operative morbidity is not readily appreciated nor easily measured. Given the ubiquitous presence of endothelium in all organs, microvascular dysfunction is likely to have a greater impact, through impaired perfusion, on non-cardiovascular complications (e.g. wound healing and end organ failure) than that which is readily appreciated.