Aging is associated with myriad changes in organ system function3. The end result is a decrease in functional reserve capacity, which can lead to adverse outcomes following any operative procedure. Furthermore, should com plications occur with an operation, residual organ function is often challenged to maintain homeostasis.
Cardiac changes of aging include ventricular hypertrophy (especially in the dissection patient population where hypertension is prevalent) and coronary artery disease. There is a concomitant reduction in ventricular compliance and a decrease in response to catecholamines resulting in a predisposition to congestive heart failure during the postoperative period when intravascular fluid shifts are present. Pulmonary function is also often impaired, with reduced chest wall compliance and decreased muscle mass decreasing pulmonary mechanics and functional reserve. There is age-related loss of pulmonary elastic recoil, which can increase residual capacity and thereby diminish gas exchange. Renal cortical atrophy and reduction in renal blood flow are age-related as well, and all contribute to impaired fluid balance in the postoperative period. These alterations also make the kidney more susceptible to dysfunction if marginal cardiac output and hypotension occur. Finally, cerebral atrophy as well as deficiencies in neurotransmitters may predispose the older patient to periods of postoperative delirium.
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Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...