Research

An operation is a physiologic event. The evidence for preparing for it is decades deep.

PERIOME exists to advance perioperative health as a measurable discipline. We generate the evidence, build the measurement science, and conduct the clinical research that turns decades of physiology into a system every surgical patient can benefit from.

Research collaboration See the platform

How much healthier can we make someone before surgery, and how completely can we help them recover afterward?

That is the central scientific question. Everything below is in service of answering it.

  • 50 millionSurgical procedures annually in the United States.
  • 2 to 8 weeksBetween scheduling and surgery, when physiologic preparation is possible but unaddressed.
  • One in fourPatients over 65 with post-operative cognitive dysfunction in the first week after major non-cardiac surgery.

Post-operative cognitive dysfunction: ISPOCD and Monk et al. Surgical volume: Lancet Commission on Global Surgery.

The standard of care

The preoperative workup evaluates surgical risk. It does not address physiologic readiness.

Labs, imaging, EKG, fasting instructions, a consent form. The standard workup identifies whether a patient is safe to undergo surgery. It says nothing about whether the body is physiologically prepared for what surgery asks of it.

The metabolic burden of fasting. The fluid deficit that begins the night before. The neurocognitive baseline at induction. Gut barrier integrity under antibiotic and anesthetic stress. The immune and repair capacity available for wound healing. None are addressed by existing preoperative protocols.

The clinical framework

Six domains, each an independent line of evidence.

The protocol targets six physiologic domains relevant to the surgical window. Each was selected for a perioperative-specific mechanism rather than general wellness.

  1. Hydration and electrolytes

    Fluid and electrolyte status entering a fasting window of 12 to 16 hours.

  2. Metabolic and recovery capacity

    The shift toward catabolism that fasting produces, immediately before repair is required.

  3. Neurocognitive resilience

    The neurocognitive baseline a patient carries into induction.

  4. Immune and inflammatory resilience

    The inflammatory and repair response to a controlled surgical injury.

  5. GI integrity and microbiome

    Gut barrier integrity under simultaneous antibiotic, fasting and anesthetic stress.

  6. Micronutrient foundation

    The substrate wound healing and recovery draw on.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

The measurement problem

You cannot manage what you cannot measure.

Risk is documented. Readiness is not. Perioperative health has never had a way to quantify whether a patient is prepared for what surgery asks of them.

The Perioperative Resilience Index is built to close that gap: a single readiness measure for the surgical window. In development; illustrative only, and not a diagnostic.

See the PRI

In the open

A discipline is built in the open, with the people advancing it.

PERIOME publishes its clinical reasoning and welcomes research collaboration from the clinicians and investigators defining this window.

Research and clinical collaboration

Patent pending. Founded 2026. Origin thesis 2023.