TORONTO–(BUSINESS WIRE)–An international group of leading heart surgeons, anesthesiologists and
critical care specialists known as ERAS®
Cardiac has published the first “Guidelines
for Perioperative Care: Enhanced Recovery After Surgery Society
Recommendations” in JAMA Surgery today. Development of these
recommendations was endorsed by the Enhanced
Recovery After Surgery (ERAS®) Society.
The landmark publication is contemporaneous with multiple ERAS sessions
being presented at the American Association for Thoracic Surgery (AATS)
meeting in Toronto, Canada. The ERAS
Society Guideline Recommendations were developed through a
two-year formal process to provide cardiac surgical programs
evidence-based protocols to enhance patient recovery following heart
surgery. The group’s mission is to facilitate optimization of the
perioperative care of cardiac surgical patients, through collaborative
discovery, analysis, expert consensus, and dissemination of best
practices that will improve both short and long-term outcomes and value
and decrease complications and readmissions.
Some of the standardized approaches addressed include: prehabilitation
to better prepare patients for surgery; pathways to manage glucose,
fluids, and temperature; antifibrinolytic and multimodal anesthesia
utilization; protocols for delirium, VTE, infection prevention, early
extubation, rigid fixation of the sternum, chest tube management to
prevent retained blood syndrome, and the use of biomarkers and
goal-directed fluid therapy to prevent acute kidney injury.
The initiative was led by Daniel T. Engelman, MD, Medical Director,
Heart & Vascular Program, Baystate Health, Springfield, MA.
“We are very excited to begin standardizing evidence-based best practice
for the perioperative care of all patients undergoing cardiac surgery,”
said Dr. Engelman. “We were the last of the surgical specialties to
publish ERAS guidelines and wish to thank our international
multidisciplinary team for their dedication to this long overdue project
to improve the patient-centered value.”
Other contributing authors include Richard Engelman, MD, Baystate
Medical Center; Judson Williams, MD, WakeMed Health and Hospitals;
Edward Boyle, MD, St. Charles Medical Center; Alexander Gregory, MD,
Cumming School of Medicine, University of Calgary; Walid Ben Ali MD and
Louis P. Perrault, MD, Ph.D., Montreal Heart Institute; Marjan
Jahangiri, MBBS MS, St. George’s, University of London; Ali Khoynezhad,
MD, PhD, MemorialCare Heart & Vascular Institute; Rakesh C. Arora, MD,
St. Boniface General Hospital; Eric Roselli, MD, Cleveland Clinic; V.
Seenu Reddy, MD, Centennial Heart & Vascular Center; Marc Gerdisch, MD,
Franciscan Health Heart Center; Jerrold Levy, MD, Duke University; Kevin
Lobdell, MD, Atrium Health; Nick Fletcher, MBBS, St George’s, University
of London; Matthias Kirsch, MD, CHUV Cardiac Surgery Centre, University
Hospital Vaudois; Gregg Nelson, MD, University of Calgary;
and Michael Grant, MD, Johns Hopkins.
“This work was possible due to this extraordinary group of international
experts who dedicated their valuable personal time away from clinical
practice, families, and other commitments,” said Dr. Judson Williams,
recipient of the first Center of Excellence Award and author of the
first US-based ERAS Cardiac results. “This is a critical first step
toward a systematic outline of evidence-based best practice, for
perioperative cardiac surgical care. The next steps will be to
collaboratively implement ERAS protocols, standardize the continuous
audit, and set benchmarks for outcomes.”
“The
ERAS® Guidelines in Cardiac Surgery represent a
substantial advance in quality healthcare delivery and a starting point
for ERAS® in the cardiac surgical specialty,” said Professor
Olle Ljungqvist, Örebro University, Sweden, Chairman of the ERAS®
Society. “Following a careful review of the literature and available
evidence, the authors present a stepwise process to improve outcomes.
The guidelines also reveal where potential knowledge gaps exist and thus
give direction for future studies. The ERAS®
Society is excited to continue to support the further development of
ERAS® principles and practice in cardiac surgery, working
together with the ERAS®
Cardiac Society to standardize evidence based-practice.”
ERAS® Cardiac is a non-profit organization with the mission to
develop evidence-based expert consensus statements promoting best
practice recovery practices. The goal is to provide hospitals better
guidance for developing local protocols that are part of a continuous
quality improvement (CQI) process for better patient care and a
reduction of postoperative complications and costs after cardiothoracic
surgery (www.erascardiac.org). Focusing
on cardiac surgery, our organization is collaborating with ERAS® (www.erassociety.org),
an organization that promotes enhanced recovery in many other surgical
specialties worldwide. Contact Alex Gregory, MD:[email protected]
The ERAS® Society (www.erassociety.org)
is an international, non-profit, multi-professional and
multi-disciplinary medical society registered in Sweden devoted to the
improvement of perioperative care, most commonly referred to as
“Enhanced Recovery After Surgery” or “ERAS.” The ERAS® Society
is comprised of leaders and developers of care for patients undergoing
surgery in a large range of surgical specialties. The ERAS®
Study Group and later the ERAS® Society was assembled by Professor Ken
Fearon, University of Edinburgh, UK and Professor Olle Ljungqvist,
Karolinska Institute, Sweden in 2001.
Contacts
Media Contact:
Paul Williams
[email protected]
(310)
569-0023
