First enhanced recovery after surgery (ERAS) guidelines and recommendations
Over the weekend, thousands of members of the thoracic surgery community came together for the 99th Annual American Association for Thoracic Surgery (AATS) Meeting. A subset of these innovators joined for a Sunday gathering hosted by the ERAS Cardiac Society and Dr. Dan Engelman, where the first expert-consensus review of evidence-based cardiac surgery ERAS practices were released. ExplORer Surgical joined this celebration to learn more about these guidelines and add to the conversation regarding effective auditing of best practices. We are excited to share what we learned!
What is ERAS?
Enhanced recovery after surgery (ERAS) represents a set of protocols used by the surgical team to ensure a patient has the best possible outcome from their surgery. One of the organizations pioneering these protocols is the ERAS Society. Initially named the ERAS Study Group, the organization first published evidence-based consensus protocols for colonic surgery in 2005 and rectal surgery in 2009. Registering as a non-profit in 2010, the society has grown to provide recommendations for gynaecology, urology, bariatric surgery and many more surgical specialties; protocols across these specialties have been associated with reduction of overall complications and length of stay of up to 50% compared with conventional perioperative management. Now, the first evidence-based protocols are available for cardiac surgery and will hopefully show similar levels of improvement.
What Kind of Guidelines are Recommended?
The ERAS Cardiac Society has organized their 22 consensus statements intro three categories: preoperative, intraoperative and postoperative strategies. Nine of these recommendations are classified as strong, with benefits far outweighing the risk of implementation. Before surgery, for example, it is highly recommended to screen for smoking and hazardous alcohol consumption, and work to stop such consumption four weeks prior. On the day of and during surgery, a care bundle should be given that includes topical intranasal decolonization, clipping immediately prior to surgery, and other high-benefit, low-risk activities. After surgery, screening for delirium should be performed using the ICU Delirium Screening Checklist and hypothermia should be prevented by raising the ambient room temperature and using forced-air warming blankets.
Where Can I Find More Information?
The examples above represent only the surface of the perioperative guidelines put forth by the ERAS Cardiac Society. If you are interested in learning more, their website, erascardiac.org, is filled with great information regarding their recommendations, past papers and presentations, and upcoming events. You can also find who is spearheading ERAS for cardiac surgery in your area, as well as how to become an ERAS Cardiac Center of Excellence. With a mission to optimize perioperative care of cardiac surgical patients through collaborative discovery, analysis, expert consensus, and dissemination of best practices, the society will ensure cardiac patients have the best recovery possible.
If you are looking for information regarding audit, compliance and data collection for ERAS protocols and guidelines, ExplORer Surgical may be able to support you. With a digital platform designed to track completion of ERAS protocols in real-time and audit compliance through ready-made dashboards and easy-to-use databases, we’d love to learn how you’re tackling ERAS implementation today and if we might be able to help.