Perioperative medicine as a clinical discipline.
Cleared is not the same as ready.
You've stood at the head of the bed. You know what a prepared patient looks like — and how rarely one arrives. The physiologic variables that shape induction and recovery are addressable. No one had built the clinical system to address them. PERIOME is that system.
PERIOME PROTOCOL is a physician-formulated perioperative program targeting the six domains most directly challenged by surgery and anesthesia. Recommended at the pre-anesthesia evaluation. Deployed through your program with no new workflow required.
The procedure. The anesthesia plan. The operating room. Each optimized over decades. Patient physiologic preparation has not.
PERIOME completes your surgical infrastructure — not by adding another product, but by building the fourth pillar of perioperative care. These are the physiologic variables your patients face every day.
PERIOME is designed to integrate with ERAS, pre-admission testing, and standard care — not compete with it. Its role is to bring more structure to the patient-facing preparation and recovery window that often remains fragmented.
ERAS tells the clinical team what to do. PERIOME prepares the patient to respond to it.
ERAS is the most evidence-supported framework in modern perioperative medicine. But every ERAS guideline assumes the patient arrives physiologically ready. PERIOME closes the gap ERAS cannot address.
Taken once daily beginning seven days pre-operatively and continuing through seven days post-operatively. On the day of surgery, patients follow their surgical team's fasting and clear-liquid guidance.
We recommend clinicians review the clinical framework in the context of each patient's procedure, medications, and perioperative plan. The Science page carries domain-level rationale and the reasoning behind notable exclusions.
Ingredients with known antiplatelet or anticoagulant profiles — including omega-3 fatty acids, curcumin, and high-dose vitamin E — are intentionally excluded. The formulation was reviewed for compatibility with the pharmacologic demands of the surgical window and the anesthetic agents commonly used within it.
One daily dose. One full course. No prescription, portal integration, or new operational layer required for basic recommendation and patient use.
What PERIOME addresses.
PERIOME PROTOCOL targets six physiologic domains relevant to the surgical window: hydration and electrolyte balance, metabolic and recovery capacity, neurocognitive resilience, immune and inflammatory resilience, GI integrity and microbiome, and micronutrient foundation. Each was selected for perioperative-specific mechanism — not general wellness. None overlap with standard ERAS pharmacologic protocols.
Full domain and formulation detail →Readiness, resolved to the physiology you manage.
The Perioperative Resilience Index™ is a composite. For the clinician it resolves into the six physiologic domains, anesthetic pharmacogenomics, and the perioperative labs that matter, so you can see exactly where a patient stands before induction.
Physiologic domains
Anesthetic pharmacogenomics · L3
Perioperative labs
Illustrative preview. The clinician readiness surface, the Perioperative Resilience Index™, and perioperative genomics are in development; patient and data shown are illustrative.
Download the Clinical Brief.
A four-page summary of the clinical rationale, the six physiologic domains, the formulation framework and exclusions, and the perioperative safety profile — structured for review by anesthesiologists, surgeons, and perioperative committees.
Download the Clinical Brief →One recommendation. A measured pathway.
A single recommendation places the patient on a physician-designed optimization pathway — one that fits inside your existing pre-operative instruction and reports readiness back to your team. No order, prescription, or portal to manage.
Elective surgical patients who would benefit from structured physiologic preparation. Read the clinical framework against their medications, comorbidities, and surgical plan.
A brief recommendation at scheduling or the pre-anesthesia evaluation is all it takes. PERIOME PROTOCOL — physician-designed and ERAS-aligned — carries the patient from seven days before surgery through the recovery window.
PERIOME prepares the patient across the surgical window and closes the loop back to the care team — surfacing adherence, physiologic signals, and readiness, so the physiology is visible before induction.
“I’d like you to start PERIOME’s perioperative preparation program before your surgery — a physician-designed regimen that begins about a week out and continues through your early recovery. Set it up at periome.com, and follow it alongside the rest of your pre-op instructions.”
Patients should follow their surgical team's fasting, medication, and day-of-surgery instructions at all times.
The protocol is the entry point. The intelligence layer is the company.
The same clinical rigor that defines PERIOME PROTOCOL's formulation is being applied to the next layer of perioperative precision: understanding how a patient's individual genetic architecture affects their response to anesthesia, surgical stress, and recovery — before they enter the OR.
Perioperative pharmacogenomics is not a future concept. The gene-drug interactions that determine anesthetic response, opioid metabolism, and neuromuscular blocker duration are well-characterized. What has been absent is a clinical infrastructure that makes this information actionable at the point of surgical care.
PERIOME is building a learning system. Every patient who prepares with the protocol generates signal. Every surgical outcome — PONV incidence, PACU time, recovery trajectory — informs what comes next. The Perioperative Resilience Index™ will give clinicians a single, quantified readiness score. Genomic intelligence will personalize that score to the individual. Day-of-surgery decision support will put it in your hands at the moment it matters. This is perioperative intelligence — the convergence of physiologic preparation, genomic profiling, and outcomes data into a system that learns from every patient and makes the next one better prepared. The clinicians who engage now are the ones shaping the standard.
Two pathways for clinicians shaping the discipline.
PERIOME is building a Clinical Advisory Council and a Clinical Fellows program for physicians who want to define the future of perioperative medicine as a recognized discipline.
Established surgeons, anesthesiologists, and perioperative leaders who want to inform PERIOME's clinical direction, review formulation and outcomes data, and help define what perioperative medicine looks like at the system level.
Inquire about the Council →Residents, fellows, and early-career attendings who want to engage with perioperative medicine as a measurable clinical discipline — through case engagement, outcomes work, and the literature that defines what comes next.
Inquire about the Fellows Program →Built from inside the operating room.
PERIOME was founded by two board-certified anesthesiologists who identified the same perioperative gap across thousands of cases — and built the clinical infrastructure to address it. Physician-led from the inside; designed to be evaluated by the clinicians who will use it.
Full founder bios on the About page.
Physician-founded. Clinician-first.
If you're ready to work together — whether on the Advisory Council, a clinical pilot, the Fellows Program, or recommending PERIOME PROTOCOL to your patients — we want to hear from you.
Thank you. The founding team will be in touch within two business days.
→ Prefer direct contact: partners@periome.com