The researchers surveyed anesthesiologists on 18 clinical items to identify the most common activities that should be questioned in the field.
The top five activities the study authors recommend questioning, with regard to the survey conducted, were:
• Baseline laboratory studies in healthy patients without significant systemic disease when blood loss during surgery is expected to be minimal
• Baseline cardiac testing or cardiac stress test in asymptomatic stable patients with known cardiac disease undergoing low-risk or moderate-risk noncardiac surgery
• Routine use of pulmonary artery catheter for cardiac surgery in patients with a low risk of blood pressure complications, especially if other diagnostic tools like an echocardiogram are being used during the procedure
• Administration of blood in young healthy patients without ongoing blood loss and with a low-normal hemoglobin concentration, unless they show symptoms or blood pressure problems
• Routine administration of specific types of intravenous fluids for replacement of blood or other fluids without appropriate indications
These recommendations were then submitted to the Choosing Wisely campaign, which is an ongoing effort by the American Board of Internal Medicine Foundation. The initiative was adopted by the American Society of Anesthesiologists and more than 130 other organizations.
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