Tools such as surgical plethysmographic index, state entropy, train-of-four monitors exist to optimize the conduct of general anesthesia in intermediate and major risk surgery as defined by the 2022 European Society of Cardiology Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Although these monitors are available on anesthesia machines they are still under-used by teams due to lack of training, practice and a real understanding of their usefulness (operation, expected benefits). When used in conjunction with General Electric's AoA Carestation Insight software, these tools could have a real impact on morbidity and mortality at 28 days post-op. The aim of this prospective monocentric interventional "before/after" study is to assess the impact of training and encouraging teams to use these tools.
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Occurrence of death after surgery in the control group
Timeframe: Day 28
Occurrence of death after surgery in the experimental group
Timeframe: Day 28
Occurence of acute myocardial infarction after surgery in the control group
Timeframe: Day 28
Occurence of acute myocardial infarction after surgery in the experimental group
Timeframe: Day 28
Occurence of arterial or venous thrombosis after surgery in the control group
Timeframe: Day 28
Occurence of arterial or venous thrombosis after surgery in the experimental group
Timeframe: Day 28
Occurence of a stroke after surgery in the control group
Timeframe: Day 28
Occurence of a stroke after surgery in the experimental group
Timeframe: Day 28
Postoperative cardiogenic shock (requiring diuretic, epinephrine or dobutamine infusion) in the control group
Timeframe: Day 28
Postoperative cardiogenic shock (requiring diuretic, epinephrine or dobutamine infusion) in the experimental group
Timeframe: Day 28
Severe acute hypotension (defined as mean arterial pressure < 50 mmHg) in the control group
Timeframe: Day 28
Severe acute hypotension (defined as mean arterial pressure < 50 mmHg) in the experimental group
Timeframe: Day 28
Cardiac arrhythmia (de novo atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation) in the control group
Timeframe: Day 28
Cardiac arrhythmia (de novo atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation) in the experimental group
Timeframe: Day 28
Postoperative episodes of sepsis and infections (according to the 2001 international definitions of sepsis) in the control group
Timeframe: Day 28
Post-operative respiratory complications: defined as the need for intubation and/or non-invasive ventilation in the event of respiratory failure in the control group
Timeframe: Day 28
Acute kidney injury in the control group: KDIGO criteria and renal replacement therapy. Baseline serum creatinine is obtained from the preoperative blood sample;
Timeframe: Day 28
Acute kidney injury in the experimental group: KDIGO criteria and renal replacement therapy. Baseline serum creatinine is obtained from the preoperative blood sample;
Timeframe: Day 28
Surgical complications in the control group: need for re-operation for any reason and radiological intervention for abscess drainage
Timeframe: Day 28
Surgical complications in the experimental group: need for re-operation for any reason and radiological intervention for abscess drainage
Timeframe: Day 28
Unplanned admission or readmission to the intensive care unit: control group
Timeframe: Day 28
Unplanned admission or readmission to the intensive care unit: experimental group
Timeframe: Day 28