Enhanced recovery after cardiac surgery

Abstract

The concept of early recovery after surgery (ERAS) consists of bundle interventions during the pre-, intra- and postoperative periods and team work. The ERAS, which is a multimodal strategy, enables one to limit the neurohumoral response to the surgery, maintain homeostasis, reduce the risk of complications, shorten the hospital stay, accelerate the return to everyday functioning, improve the patient’s satisfaction, achieve a satisfactory quality of life and finally reduce the treatment costs and eliminate any redundant and ineffective practices. Almost every patient can be classified for the ERAS strategy except for patients undergoing urgent and emergency surgery. The necessity to give up ERAS can result from poor organisation and management. Moreover, the procedure itself can be the cause of the lack of adherence to the planned standard. It is necessary to use protocols and checklists. While fulfilling this doctrine, the anaesthesiologist becomes a perioperative specialist.

Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: a multicentre qualitative study

“…There is currently sufficient evidence to support the hypothesis that the implementation of ERAS can indeed effectively improve the efficiency of the use of health service resources 14 and improve patient satisfaction with the diagnosis and treatment results. 15 16 However, there are variations in the implementation of ERAS for different regions, hospitals at different levels and experts in different disciplines, [17][18][19] which limits the application and popularisation of ERAS.…”

Post-operative nursing bleeding management in mitral valve repair-re-exploration patient during early post-operative period: Case report

“…According to ERAS, patients should receive 1.5-1.7 liters of fluid per day to meet their fluid needs (Kołodziej et al, 2019). In this case, crystalloid fluids were given as much as 1500 cc/24 hours.…”

Delirium after Cardiac Surgery—A Narrative Review

“…A study in 2007 in the United Kingdom found that of the 25,000 coronary artery bypass graft (CABG) surgeries performed each year, almost 25% of the patients are >70, and 8% are >75 [37]. Most institutions focus on the preoperative optimization of these patients in terms of alcohol and smoking cessation, blood glucose control, nutritional deficiency correction, avoidance of prolonged fasting, increased use of patient engagement technology, and comprehensive rehabilitation [5]. The identification of cognitive issues, substance and alcohol use disorder, history of mood disorders, and frailty of patients should additionally be considered for targeted surveillance and management during the perioperative course [4].…”

“…The first 30 days after cardiopulmonary bypass have the most significant effects on a cardiac patient's quality of life; therefore, early recovery after surgery (ERAS), defined as a widespread protocol of perioperative interventions designed to improve outcomes, are essential in preventing postoperative neurocognitive complications [5].…”