Enhanced Recovery in Surgical Intensive Care: A Review

Jovanović, Gordana; Jakovljević, Dea Karaba; Lukić-Šarkanović, Mirka

doi:10.3389/fmed.2018.00256

Cited by 9 publications

(9 citation statements)

References 42 publications

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“…Vigilance is required to prevent neonatal AWD during the entire perioperative period [ 20 , 21 ]. Because of the lack of nutritional reserve and the poor tolerance of surgery by neonates, perioperative nutritional support should be strengthened to improve the surgical success rate [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

et al. 2021

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Background Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, and neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD and construct a predictive model. Methods The clinical data of 453 cases that underwent neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were identified. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anaemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD. Results The incidence of neonatal AWD was 6.0% (27/453), among which partial wound dehiscence accounted for 4.9% (22/453) and complete wound dehiscence accounted for 1.1% (5/453). Hypoproteinemia and incision type were the independent risk factors for neonatal AWD, and weight at admission was a protective factor for AWD in the multivariate models. All these factors were incorporated to construct a nomogram, and a calibration curve was plotted. The result indicated that the actual risk was close to the predicted risk when the predicted risk rate was greater than about 35%. Conclusions Neonatal AWD is closely related to hypoproteinemia and incision contamination. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery. Key messages Neonatal abdominal wound dehiscence (AWD) has a serious consequence and the incidence of neonatal AWD was about 6.0% and the complete AWD morbidity is 1.1%. Hypoproteinemia and incision type were the independent risk factors for neonatal AWD. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery.

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Section: Discussionmentioning

confidence: 99%

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

et al. 2021

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“…Vigilance is required to prevent neonatal AWD during the entire perioperative period [22,23]. Because of the lack of nutritional reserve and the poor tolerance of surgery by neonates, perioperative nutritional support should be strengthened to improve the surgical success rate [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Congenital defects of gastric musculature (12) Mesenteric/omental cyst (16) Neonatal necrotizing enterocolitis with perforation (23) residual diseases ofomphalomesenteric duct (55)…”

mentioning

confidence: 99%

Risk Factors for Abdominal Wound Dehiscence in Neonates: A Retrospective Cohort Study

Duan

Zhang

Jiang

et al. 2020

Preprint

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Background: Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD.Methods: The clinical data for 453 cases of neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were found. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD.Results: The incidence of neonatal AWD was 6.0% (27/453), of which partial wound dehiscence 4.9% (22/453) and complete wound dehiscence 1.1% (5/453). Anemia, hypoproteinemia, and wound contamination were the main risk factors for neonatal AWD. The AWD-free survival rates for infants with severe anemia and mild to moderate anemia were 83.3% and 91.2%, respectively. The AWD-free survival rates for those with hypoproteinemia, type II and type III incision were 88.0%, 95.1% and 87.1%, respectively.Conclusion: Neonatal AWD is closely related to anemia, hypoproteinemia, and incision contamination. It is of great significance for the prevention of neonatal AWD to strengthen nutritional support, correct preoperative anemia, and control infection.Trial registration: Research Registry, researchregistry5350. Registered 01 February 2020 - Retrospectively registered, https://www.researchregistry.com/browse-the-registry#home/registrationdetails/5e359028eef79c001577fa18/

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“…Enhanced Recovery After Surgery (ERAS) protocols help in lowering the stress response and maintain organ function thereby achieving early recovery post-surgery. 1,2 ERAS has the initial introduction in the late 1980's, the publications on ERAS has expanded with more than 1300 articles published in the last 5 years. 3 Fig.…”

Section: Introductionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) for the anaesthesiologist

Valecha¹,

Vohra²,

Patil³

et al. 2020

IJCA

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Enhanced recovery after surgery (ERAS) protocol consists of entire spectrum of pre, intra and postoperative designed to enhance patient outcomes. Since its first introduction for major abdominal surgery in the 1990's, ERAS protocols have been successfully used extensively in many countries in several major surgical procedures. When effectively implemented, ERAS resulted in reduction in hospitalization, improvement in satisfaction of the patients, and reduction in complication rate without an increase in readmissions. Implementation of ERAS in India has also positively affected the patient experience and led to efficient utilization of valuable hospital resources. Many of the ERAS components are linked to the anaesthesia team. Anaesthesiologists help in preparing anaesthesia, they also ascertain the fasting regime in preoperative period, assess premedication, and introduce prophylaxis for post-operative nausea and vomiting (PONV). Intraoperatively, they introduce low sodium fluid therapy, help in preventing hypothermia, and utilize short acting drugs. They also help in important decision making during postoperative analgesia. An anaesthesiologist role is foremost important in the implementation of ERAS protocol. The article aims to discuss the various components of ERAS and the role of anaesthesiologist in implementing them.

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Enhanced Recovery in Surgical Intensive Care: A Review

Cited by 9 publications

References 42 publications

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study

Risk Factors for Abdominal Wound Dehiscence in Neonates: A Retrospective Cohort Study

Enhanced recovery after surgery (ERAS) for the anaesthesiologist

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