Cardiac Enhanced Recovery After Surgery: Early Outcomes in a Community Setting
| Autor: | Rachel Born, Rawn Salenger, Linda F. Barr, Jennifer Yeh, Amanda Rea, Michael J. Boss, Kate Knott, Sari D. Holmes |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pain Postoperative Lightheadedness Nausea business.industry Length of Stay Dizziness Community hospital Cardiac surgery Analgesics Opioid Anesthesia medicine Community setting Humans Surgery Preoperative fasting medicine.symptom Cardiology and Cardiovascular Medicine business Enhanced Recovery After Surgery Enhanced recovery after surgery Patient education Retrospective Studies |
| Zdroj: | The Annals of thoracic surgery. 113(6) |
| ISSN: | 1552-6259 |
| Popis: | Enhanced Recovery After Surgery (ERAS) programs have demonstrated improved outcomes in noncardiac surgery. More recently, ERAS has been applied to cardiac surgery with promising results. We have implemented cardiac ERAS at our community-based program, aiming to improve all phases of care, and now report our early results.We retrospectively analyzed 73 consecutive patients treated with ERAS care compared with 74 patients treated before implementing ERAS. Our ERAS program consisted of 6 perioperative care bundles including enhanced patient education, shortened preoperative fasting period and oral carbohydrate load, postoperative nausea prophylaxis, multimodal opioid-sparing analgesia, early extubation, and early mobilization.ERAS patients required significantly less opioids captured as total morphine milligram equivalents (MME) (median 35.0 vs 75.3; P.001), less nausea as determined by fewer total ondansetron rescue doses (median 0 vs 0.5; P = .011), and less lightheadedness (P = .028) compared with pre-ERAS patients. Postoperative mobility was significantly better (postoperative day 4: 95% vs 81%; P = .013) and postoperative length of stay was lower for ERAS care but did not reach statistical significance (median 4 days vs 5 days; P = .06). There was no difference in pain or glucose control or in early extubation.Cardiac ERAS significantly decreased opioid use, nausea, and lightheadedness and improved functional outcome for cardiac surgical patients in a community hospital. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|