Initial experience introducing an enhanced recovery program in congenital cardiac surgery

Commentary: Enhanced recovery program after congenital heart surgery: Promising baby steps

“…Adherence with several ERAS program protocols was suboptimal, including parameters such as ingestion of glucosecontaining beverage before surgery (17%), hypoglycemia during surgery (17%), postoperative nausea and vomiting prevention (33%), and mechanical ventilation less than 8 hours (54%), as well as many others. 7 Nevertheless, the results obtained seem congruent with previous studies of ERAS implementation in the pediatric and cardiothoracic surgical populations. [3][4][5][6] Through this early experience, the authors recognize there is much to improve.…”

“…Results showed reduced duration of mechanical ventilation, intensive care unit length of stay, and readmission within 30 days compared with pre-ERAS program patients. 7 Further, there was no increase in reported complications or reinterventions. However, the change in overall postoperative hospital length of stay was not significant.…”

“…1 ERAS programs have yielded significant results in many surgical arenas, including abdominal surgery, cardiothoracic, and pediatric surgical populations, but have yet to be rigorously examined in the pediatric cardiothoracic surgical population. [2][3][4][5][6] In the current issue of the Journal, Roy and colleagues 7 report the preliminary outcomes of ERAS program use after congenital heart surgery in a targeted population with low comorbidities at a major children's hospital. Results showed reduced duration of mechanical ventilation, intensive care unit length of stay, and readmission within 30 days compared with pre-ERAS program patients.…”

Physiology Principles Underlying Goal Directed Therapies in Children

“…Considering enhanced recovery after surgery (ERAS) point of view [23,[29][30][31][32][33][34][35][36] The objectives of ERAS is to reduce the perioperative stress which can have adverse consequences on postoperative recovery [23,29,30]. ERAS englobes measures which aim to reduce perioperative stress.…”

Minimally Invasive Cardiac Surgical Procedures in Children

“…While this type of programmed management of the entire patient experience is now common in adult cardiac surgical programs, implementation of ERAS in pediatric cardiac patients is new, although early indications suggest that they can complement a pediatric minimally invasive surgery program. 17 In particular, anesthetic management with avoidance of high-dose opioids along with antiemetic medications can reduce the nausea and vomiting early after surgery that is a significant source of discomfort for the children and their parents. Increased use of local and regional anesthetic agents, particularly long-acting analgesics, has significantly reduced narcotic use and patient comfort, while maintaining adequate pain control.…”