Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Critical Care Medicine, Massachusetts General Hospital Heart Center, The Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Cardiothorac Vasc Anesth. 2020 Nov;34(11):3104-3112. doi: 10.1053/j.jvca.2019.12.022. Epub 2019 Dec 27.
The use of Enhanced Recovery After Surgery (ERAS) protocols among various surgical subspecialties is increasing, including in cardiac surgery. The goal of these protocols is to optimize patient outcomes and satisfaction and improve the value of healthcare delivered. Cardiac ERAS protocols are divided into the following 3 stages of perioperative care: preoperative, intraoperative, and postoperative. ERAS strategies have been shown to work synergistically to reduce the length of hospital stay, postoperative complications, hospital cost, and opioid consumption; increase patient satisfaction; and result in less and early extubation. The ERAS team should consist of clinicians involved in the patient's care throughout the entire ERAS process. A cardiac ERAS program is an example of value-based care applied to a specific surgical specialty with goals to improve patient satisfaction, provide earlier recovery, and reduce hospital cost. This narrative review details the updates and gaps in the literature regarding the efficacy and utility of an ERAS protocol in cardiac surgery, outlines the individual components of a cardiac surgery ERAS protocol, and describes the implementation science that can be used to execute a cardiac ERAS protocol successfully.
外科各亚专业越来越多地使用术后快速康复（ERAS）方案，包括心脏外科。这些方案的目的是优化患者的预后和满意度，提高所提供医疗保健的价值。心脏 ERAS 方案分为围手术期护理的以下 3 个阶段：术前、术中和术后。ERAS 策略已被证明可以协同作用，缩短住院时间、减少术后并发症、降低医院成本和阿片类药物的使用；增加患者满意度；并实现更早的拔管。ERAS 团队应由参与患者整个 ERAS 过程的临床医生组成。心脏 ERAS 方案是一种基于价值的护理模式，适用于特定的外科专业，旨在提高患者满意度、提供更早的康复和降低医院成本。本综述详细介绍了心脏外科中 ERAS 方案的有效性和实用性方面的最新研究进展和差距，概述了心脏外科 ERAS 方案的各个组成部分，并描述了可用于成功实施心脏 ERAS 方案的实施科学。
