The Benefits of Enhanced Recovery After Surgery Programs and Their Application in Cardiothoracic Surgery

Jessica K. Brown, Karanbir Singh, Razvan Dumitru, Edward Chan, Min P. Kim

Research output: Contribution to journalReview articlepeer-review

39 Scopus citations

Abstract

The perioperative care of the surgical patient is undergoing a paradigm shift. Enhanced Recovery After Surgery (ERAS) programs are becoming the standard of care and best practice in many surgical specialties throughout the world. ERAS is a multimodal, multidisciplinary, evidence-based approach to care of the surgical patient that aims to optimize perioperative management and outcomes. Implementation, however, has been slow because it challenges traditional surgical doctrine. The key elements of ERAS Pathways strive to reduce the response to surgical stress, decrease insulin resistance, and maintain anabolic homeostasis to help the patient return to baseline function more quickly. Data suggest that these pathways have produced not only improvements in clinical outcome and quality of care but also significant cost savings. Large trials reveal an increase in 5-year survival and a decrease in immediate complication rates when strict compliance is maintained with all pathway components. Years of success using ERAS in colorectal surgery have helped to establish a body of evidence through a number of randomized controlled trials that encourage application of these pathways in other surgical specialties.

Original languageEnglish (US)
Pages (from-to)77-88
Number of pages12
JournalMethodist DeBakey cardiovascular journal
Volume14
Issue number2
DOIs
StatePublished - Apr 1 2018

Keywords

  • ERAS
  • cardiothoracic surgery
  • enhanced recovery after surgery
  • length of stay
  • lung resection
  • multimodal analgesia
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Medicine(all)

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