Journal article
Enhanced Recovery Pathways for Cardiac Surgery
Current pain and headache reports, v 23(4), pp 28-28
01 Apr 2019
PMID: 30868281
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose of ReviewEnhanced recovery after surgery (ERAS) has become a widespread topic in perioperative medicine over the past 20years. The goals of ERAS are to improve patient outcomes and perioperative experience, reduce length of hospital stay, minimize complications, and reduce cost. Interventions and factors before, during, and after surgery all potentially play a role with the cumulative effect being superior quality of patient care.Recent FindingsPreoperatively, patient and family education, optimization of nutritional status, and antibiotic prophylaxis all improve outcomes. Recovery is also expedited by the use of multimodal analgesia, regional anesthesia, and opioid reducing approaches. Intraoperatively, the anesthesiologist can have an impact by using less-invasive monitors appropriately to guide fluid and hemodynamic management as well as maintaining normothermia. Postoperatively, early enteral feeding, mobilization, and removal of invasive lines support patient recovery. Implementation of ERAS protocol in cardiac surgery faces challenges by some unique perioperative perspectives in cardiac surgery, such as systemic anticoagulation, use of cardiopulmonary bypass, significantly more hemodynamic variations, larger volume replacement, postoperative intubation and mechanical ventilation and associated sedation, and potentially significantly more co-existing morbidities than other surgical procedures.SummaryERAS in cardiac surgery may benefit patients more related to its high risk and high cost nature. This manuscript specifically reviews the unique aspects of enhanced recovery in cardiac surgery.
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Details
- Title
- Enhanced Recovery Pathways for Cardiac Surgery
- Creators
- Scott R. Coleman - Hahnemann University HospitalMing Chen - Department of Anesthesiology, Hubei Women and Children's Hospital, 745 Wuluo Road, Hongshan, Wuhan, 430070, Hubei, China.Srikant Patel - Hahnemann University HospitalHong Yan - Central Hospital of WuhanAlan D. Kaye - Louisiana State University Health Sciences Center New OrleansMarcus Zebrower - Hahnemann University HospitalJulie A. Gayle - Louisiana State University Health Sciences Center New OrleansHenry Liu - Hahnemann University HospitalRichard D. Urman - Brigham and Women's Hospital
- Publication Details
- Current pain and headache reports, v 23(4), pp 28-28
- Publisher
- Springer Nature
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:000461147100003
- Scopus ID
- 2-s2.0-85062844250
- Other Identifier
- 991019168790804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology