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胸外科增强康复指南的审视

Examination of the enhanced recovery guidelines in thoracic surgery.

作者信息

Teeter Emily G, Kolarczyk Lavinia M, Popescu Wanda M

机构信息

Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA.

出版信息

Curr Opin Anaesthesiol. 2019 Feb;32(1):10-16. doi: 10.1097/ACO.0000000000000681.

Abstract

PURPOSE OF REVIEW

Enhanced Recovery After Thoracic Surgery (ERATS) has gained momentum over the past few years, although the evidence base and expert recommendations lag behind other specialties. This review will present and examine key points from the first guidelines for enhanced recovery after lung surgery, released in 2018, jointly sponsored by the European Society of Thoracic Surgeons and the Enhanced Recovery After Surgery Society.

RECENT FINDINGS

The recently released guidelines present core components of enhanced recovery as they pertain to lung resection surgery. Although evidence is still sparse in some areas, the guidelines summarize the available literature and incorporate levels of recommendation based upon the strength of available data as well as expert consensus. As of yet, the relative contribution of individual ERATS components to improvement in outcomes is unclear, but overall compliance does seem to be linked to positive results. Since the creation of the guidelines, additional literature related to ERATS has been released, and it will be incorporated and discussed into our review.

SUMMARY

The creation of guidelines for enhanced recovery after lung resection will provide the thoracic anesthesiologist a framework upon which to build a comprehensive perioperative anesthetic plan.

摘要

综述目的

尽管证据基础和专家建议落后于其他专科,但胸外科手术后加速康复(ERATS)在过去几年中已得到推广。本综述将介绍并审视2018年由欧洲胸外科医师协会和外科手术后加速康复协会联合发布的首份肺手术后加速康复指南中的要点。

最新发现

最近发布的指南介绍了与肺切除手术相关的加速康复的核心内容。尽管某些领域的证据仍然稀少,但该指南总结了现有文献,并根据现有数据的强度以及专家共识纳入了推荐等级。到目前为止,ERATS各个组成部分对改善预后的相对贡献尚不清楚,但总体依从性似乎确实与积极结果相关。自指南发布以来,已发布了与ERATS相关的其他文献,我们将在综述中纳入并讨论这些文献。

总结

肺切除术后加速康复指南的制定将为胸科麻醉医生提供一个框架,在此基础上制定全面的围手术期麻醉计划。

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