Enhanced Recovery After Surgery (ERAS) Society Recommendations for Neonatal Perioperative Care.

Autor:	Pilkington M; Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Nelson G; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.; Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Pentz B; Department of Surgery, University of Calgary, Calgary, Alberta, Canada., Marchand T; Department of Surgery, University of Calgary, Calgary, Alberta, Canada., Lloyd E; Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Chiu PPL; Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada., de Beer D; Department of Anaesthetics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom., de Silva N; Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.; Department of Pediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada., Else S; Department of Anesthesia, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Fecteau A; Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada., Giuliani S; Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.; Cancer Section, Developmental Biology and Cancer Programme, University College London Great Ormond Street Institute of Child Health, London, United Kingdom., Hannam S; Department of Neonatology, Heart and Lung Directorate, Great Ormond Street Hospital for Children, London, United Kingdom., Howlett A; Department of Pediatrics, Division of Neonatology, University of Calgary, Calgary, Alberta, Canada., Lee KS; Department of Pediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada., Levin D; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada., O'Rourke L; Department of Neonatology, Heart and Lung Directorate, Great Ormond Street Hospital for Children, London, United Kingdom., Stephen L; Alberta Children's Hospital, Calgary, Alberta, Canada., Wilson L; Department of Anesthesia, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom., Brindle ME; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.; Division of Pediatric Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	JAMA surgery [JAMA Surg] 2024 Sep 01; Vol. 159 (9), pp. 1071-1078.
DOI:	10.1001/jamasurg.2024.2044
Abstrakt:	Importance: Neonates requiring surgery are often cared for in neonatal intensive care units (NICUs). Despite a breadth of surgical pathology, neonates share many perioperative priorities that allow for the development of unit-wide evidence-based Enhanced Recovery After Surgery (ERAS) recommendations. Observations: The guideline development committee included pediatric surgeons, anesthesiologists, neonatal nurses, and neonatologists in addition to ERAS content and methodology experts. The patient population was defined as neonates (first 28 days of life) undergoing a major noncardiac surgical intervention while admitted to a NICU. After the first round of a modified Delphi technique, 42 topics for potential inclusion were developed. There was consensus to develop a search strategy and working group for 21 topic areas. A total of 5763 abstracts were screened, of which 98 full-text articles, ranging from low to high quality, were included. A total of 16 recommendations in 11 topic areas were developed with a separate working group commissioned for analgesia-related recommendations. Topics included team communication, preoperative fasting, temperature regulation, antibiotic prophylaxis, surgical site skin preparation, perioperative ventilation, fluid management, perioperative glucose control, transfusion thresholds, enteral feeds, and parental care encouragement. Although clinically relevant, there were insufficient data to develop recommendations concerning the use of nasogastric tubes, Foley catheters, and central lines. Conclusions and Relevance: Despite varied pathology, neonatal perioperative care within NICUs allows for unit-based ERAS recommendations independent of the planned surgical procedure. The 16 recommendations within this ERAS guideline are intended to be implemented within NICUs to benefit all surgical neonates.
Databáze:	MEDLINE
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