Clinical Research Directory

Inclusion Criteria: 1. Scheduled for major non-cardiac surgery 2. Having general anaesthesia 3. Are designated ASA physical status ≥2 (ranging from mild systemic disease through severe systemic disease that is a constant threat to life) 4. Subject to at least one of the following risk factors: 1. Age ≥ 65 years 2. History of peripheral arterial surgery 3. History of coronary artery disease 4. History of stroke or transient ischemic attack 5. Serum creatinine \>175 µmol/L (\>2.0 mg/dl) 6. Diabetes requiring medication 7. Current smoking or 15 pack-year history of smoking tobacco 8. Preoperative high-sensitivity troponin T \>14 ng/L or troponin I equivalent, defined as ≥15 ng/L (Abbott assay),75 19 ng/L (Siemens assay, \[Borges, unpublished\]), or 25% of the 99% percentile for other assays; 9. B-type natriuretic protein (BNP) ≥ 80 ng/L or N-terminal B-type natriuretic protein (NT-ProBNP) ≥ 200 ng/L.76,77 10. History of atrial fibrillation 11. Chronically taking at least one anti-hypertensive medication Exclusion Criteria: 1. Are scheduled for carotid artery surgery 2. Are scheduled for intracranial surgery 3. Are scheduled for pheochromocytoma surgery 4. Require preoperative intravenous vasoactive medications 5. Active decompensated congestive heart failure (documented EF \< 30%) 6. Chronic Kidney Disease (eGFR\< 30 mL/min) 7. History of organ transplantation 8. Rectal surgical procedures 9. Patients receiving preoperative bowel preparation 10. Severe pulmonary edema