ERAS protocol on elective cardiac surgery: a theoretical and practical review

Abstract

Objective: to describe and analyze current scientific research regarding the strategies of the ERAS (Enhanced Recovery After Surgery ) protocol on elective cardiac surgery in adult patients, in such a way that by addressing their needs, recovery is optimized and perioperative complications in this type of procedure are reduced. Material and methods: a bibliographic review was carried out on the strategies adopted by the ERAS protocol in cardiac surgery. Primary information sources as scientific articles and Secondary sources were used for example: MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials and ELSEVIER. The selected articles described the use of the ERAS protocol between January 2010 until December 2020 by taking into account the inclusion and exclusion parameters.

Results: of 277 scientific articles identified, only 40 were included in this review. The results determined individual strategies that currently constitute the basis of the ERAS protocol with the purpose of facilitating the reduction of the surgical site infection, the shortening of stay in the hospital, to have less kidney injury, not to have indication of perioperative transfusions, to decreased risk of postoperative delirium and lower requirement of perioperative opioids.

Conclusion: the ERAS protocol should be not only implemented in the perioperative care of cardiac patients, but also updated according to the developments in anesthesia and cardiac surgery.