Progress in the application of enhanced recovery after surgery concept in perioperative period of cardiac surgery_West China Medical Journal

Authors：

YE Yuancai ¹ , WANG Weisi ¹ , YU Hong ¹ ,  LIANG Peng ^1,2

1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Peng, Email: 39485572@qq.com

Keywords：

Cardiac surgery; enhanced recovery after surgery; perioperative period; pulmonary complications

DOI：

10.7507/1002-0179.202210151

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

The concept of enhanced recovery after surgery (ERAS) is composed of multidisciplinary, multimodal, and evidence-based approaches, providing a safe and cost-effective method for perioperative management to improve patient prognosis without increasing the incidence of complications. At present, ERAS for cardiac surgery has developed slowly. This article provides a review of the application and prospects of ERAS concept in the perioperative period of cardiac surgery. The measures for applying ERAS concept to the perioperative period of cardiac surgery are divided into three parts: preoperative, intraoperative, and postoperative. The aim is to provide information for the perioperative management of cardiac surgery patients and assist in their rapid recovery during the perioperative period.

Citation： YE Yuancai, WANG Weisi, YU Hong, LIANG Peng. Progress in the application of enhanced recovery after surgery concept in perioperative period of cardiac surgery. West China Medical Journal, 2023, 38(6): 919-923. doi: 10.7507/1002-0179.202210151 Copy

1.	Shida D, Tagawa K, Inada K, et al. Modified enhanced recovery after surgery (ERAS) protocols for patients with obstructive colorectal cancer. BMC Surg, 2017, 17(1): 18.
2.	Ni X, Jia D, Chen Y, et al. Is the enhanced recovery after surgery (ERAS) program effective and safe in laparoscopic colorectal cancer surgery? A meta-analysis of randomized controlled trials. J Gastrointest Surg, 2019, 23(7): 1502-1512.
3.	Engelman RM, Rousou JA, Flack JE 3rd, et al. Fast-track recovery of the coronary bypass patient. Ann Thorac Surg, 1994, 58(6): 1742-1746.
4.	Zaouter C, Imbault J, Labrousse L, et al. Association of robotic totally endoscopic coronary artery bypass graft surgery associated with a preliminary cardiac enhanced recovery after surgery program: a retrospective analysis. J Cardiothorac Vasc Anesth, 2015, 29(6): 1489-1497.
5.	Fleming IO, Garratt C, Guha R, et al. Aggregation of marginal gains in cardiac surgery: feasibility of a perioperative care bundle for enhanced recovery in cardiac surgical patients. J Cardiothorac Vasc Anesth, 2016, 30(3): 665-670.
6.	Williams JB, McConnell G, Allender JE, et al. One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program. J Thorac Cardiovasc Surg, 2019, 157(5): 1881-1888.
7.	Li M, Zhang J, Gan TJ, et al. Enhanced recovery after surgery pathway for patients undergoing cardiac surgery: a randomized clinical trial. Eur J Cardiothorac Surg, 2018, 54(3): 491-497.
8.	Engelman DT, Ben Ali W, Williams JB, et al. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA Surg, 2019, 154(8): 755-766.
9.	Narayan P, Kshirsagar SN, Mandal CK, et al. Preoperative glycosylated hemoglobin: a risk factor for patients undergoing coronary artery bypass. Ann Thorac Surg, 2017, 104(2): 606-612.
10.	Lee EH, Kim WJ, Kim JY, et al. Effect of exogenous albumin on the incidence of postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass surgery with a preoperative albumin level of less than 4.0 g/dl. Anesthesiology, 2016, 124(5): 1001-1011.
11.	Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: a systematic review of randomised controlled trials. J Clin Nurs, 2019, 28(17/18): 3096-3116.
12.	Feguri GR, de Lima PRL, de Cerqueira Borges D, et al. Preoperative carbohydrate load and intraoperatively infused omega-3 polyunsaturated fatty acids positively impact nosocomial morbidity after coronary artery bypass grafting: a double-blind controlled randomized trial. Nutr J, 2017, 16(1): 24.
13.	Ni R, Liu M, Huang S, et al. Effects of eHealth Interventions on quality of life and psychological outcomes in cardiac surgery patients: systematic review and meta-analysis. J Med Internet Res, 2022, 24(8): e40090.
14.	Mutters NT, De Angelis G, Restuccia G, et al. Use of evidence-based recommendations in an antibiotic care bundle for the intensive care unit. Int J Antimicrob Agents, 2018, 51(1): 65-70.
15.	Newland RF, Baker RA, Mazzone AL, et al. Rewarming temperature during cardiopulmonary bypass and acute kidney injury: a multicenter analysis. Ann Thorac Surg, 2016, 101(5): 1655-1662.
16.	Allen KB, Thourani VH, Naka Y, et al. Rigid plate fixation versus wire cerclage: patient-reported and economic outcomes from a randomized trial. Ann Thorac Surg, 2018, 105(5): 1344-1350.
17.	Allen KB, Thourani VH, Naka Y, et al. Randomized, multicenter trial comparing sternotomy closure with rigid plate fixation to wire cerclage. J Thorac Cardiovasc Surg, 2017, 153(4): 888-896.e1.
18.	Myles PS, Smith JA, Forbes A, et al. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med, 2017, 376(2): 136-148.
19.	Kim MH, Kim MS, Lee JH, et al. Intravenously administered lidocaine and magnesium during thyroid surgery in female patients for better quality of recovery after anesthesia. Anesth Analg, 2018, 127(3): 635-641.
20.	Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth, 2017, 118(3): 317-334.
21.	Salameh A, Greimann W, Vollroth M, et al. Lung protection in cardio-pulmonary bypass. J Physiol Pharmacol, 2017, 68(1): 99-116.
22.	Arslantas MK, Kara HV, Tuncer BB, et al. Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections. J Thorac Cardiovasc Surg, 2015, 149(1): 314-320, 321.e1.
23.	Güldner A, Kiss T, Serpa Neto A, et al. Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers. Anesthesiology, 2015, 123(3): 692-713.
24.	Furnary AP, Wu Y. Eliminating the diabetic disadvantage: the portland diabetic project. Semin Thorac Cardiovasc Surg, 2006, 18(4): 302-308.
25.	Greisen J, Nielsen DV, Sloth E, et al. High thoracic epidural analgesia decreases stress hyperglycemia and insulin need in cardiac surgery patients. Acta Anaesthesiol Scand, 2013, 57(2): 171-177.
26.	Higgs M, Fernandez R. The effect of insulin therapy algorithms on blood glucose levels in patients following cardiac surgery: a systematic review. JBI Database System Rev Implement Rep, 2015, 13(5): 205-243.
27.	Carli F, Baldini G. Fast-track surgery: it is time for the anesthesiologist to get involved!. Minerva Anestesiol, 2011, 77(2): 227-230.
28.	Radbruch L, Glaeske G, Grond S, et al. Topical review on the abuse and misuse potential of tramadol and tilidine in Germany. Subst Abus, 2013, 34(3): 313-320.
29.	Joshi SS, Jagadeesh AM. Efficacy of perioperative pregabalin in acute and chronic post-operative pain after off-pump coronary artery bypass surgery: a randomized, double-blind placebo controlled trial. Ann Card Anaesth, 2013, 16(3): 180-185.
30.	Menda F, Köner O, Sayın M, et al. Effects of single-dose gabapentin on postoperative pain and morphine consumption after cardiac surgery. J Cardiothorac Vasc Anesth, 2010, 24(5): 808-813.
31.	Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev, 2016, 3: CD005563.
32.	Bergeron N, Dubois MJ, Dumont M, et al. Intensive care delirium screening checklist: evaluation of a new screening tool. Intensive Care Med, 2001, 27(5): 859-864.
33.	Xu F, Zhang C, Liu C, et al. Relationship between first 24-h mean body temperature and clinical outcomes of post-cardiac surgery patients. Front Cardiovasc Med, 2021, 8: 746228.
34.	Yu PJ, Cassiere HA, Kohn N, et al. Impact of postoperative hypothermia on outcomes in coronary artery bypass surgery patients. J Cardiothorac Vasc Anesth, 2017, 31(4): 1257-1261.
35.	Grieshaber P, Heim N, Herzberg M, et al. Active chest tube clearance after cardiac surgery is associated with reduced reexploration rates. Ann Thorac Surg, 2018, 105(6): 1771-1777.
36.	Sachdeva A, Dalton M, Lees T. Graduated compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev, 2018, 11(11): CD001484.
37.	Ho KM, Bham E, Pavey W. Incidence of venous thromboembolism and benefits and risks of thromboprophylaxis after cardiac surgery: a systematic review and meta-analysis. J Am Heart Assoc, 2015, 4(10): e002652.
38.	Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation, 2011, 124(23): e652-735.
39.	Ge M, Wang Z, Chen T, et al. Risk factors for and outcomes of prolonged mechanical ventilation in patients received DeBakey type I aortic dissection repairment. J Thorac Dis, 2021, 13(2): 735-742.
40.	Barker J, Martino R, Reichardt B, et al. Incidence and impact of dysphagia in patients receiving prolonged endotracheal intubation after cardiac surgery. Can J Surg, 2009, 52(2): 119-124.
41.	Bianchi P, Constantine A, Costola G, et al. Ultra-fast-track extubation in adult congenital heart surgery. J Am Heart Assoc, 2021, 10(11): e020201.
42.	Subramaniam K, DeAndrade DS, Mandell DR, et al. Predictors of operating room extubation in adult cardiac surgery. J Thorac Cardiovasc Surg, 2017, 154(5): 1656-1665.e2.
43.	Kheterpal S, Vaughn MT, Dubovoy TZ, et al. Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis. Anesthesiology, 2020, 132(6): 1371-1381.
44.	Mao H, Katz N, Ariyanon W, et al. Cardiac surgery-associated acute kidney injury. Blood Purif, 2014, 37(Suppl 2): 34-50.
45.	O’Neal JB, Shaw AD, Billings FT 4th. Acute kidney injury following cardiac surgery: current understanding and future directions. Crit Care, 2016, 20(1): 187.
46.	Scott NB, Turfrey DJ, Ray DA, et al. A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg, 2001, 93(3): 528-535.
47.	Zarbock A, Kellum JA, Van Aken H, et al. Long-term effects of remote ischemic preconditioning on kidney function in high-risk cardiac surgery patients: follow-up results from the RenalRIP trial. Anesthesiology, 2017, 126(5): 787-798.
48.	Kumar AB, Suneja M, Bayman EO, et al. Association between postoperative acute kidney injury and duration of cardiopulmonary bypass: a meta-analysis. J Cardiothorac Vasc Anesth, 2012, 26(1): 64-69.
49.	Jia P, Teng J, Zou J, et al. miR-21 contributes to xenon-conferred amelioration of renal ischemia-reperfusion injury in mice. Anesthesiology, 2013, 119(3): 621-630.
50.	Haase-Fielitz A, Haase M, Bellomo R, et al. Perioperative hemodynamic instability and fluid overload are associated with increasing acute kidney injury severity and worse outcome after cardiac surgery. Blood Purif, 2017, 43(4): 298-308.
51.	Makaryus R, Miller TE, Gan TJ. Current concepts of fluid management in enhanced recovery pathways. Br J Anaesth, 2018, 120(2): 376-383.
52.	Osawa EA, Rhodes A, Landoni G, et al. Effect of perioperative goal-directed hemodynamic resuscitation therapy on outcomes following cardiac surgery: a randomized clinical trial and systematic review. Crit Care Med, 2016, 44(4): 724-733.
53.	Burgess LC, Wainwright TW. What is the evidence for early mobilisation in elective spine surgery? A narrative review. Healthcare (Basel), 2019, 7(3): 92.
54.	Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg, 2018, 126(6): 1883-1895.
55.	Willcutts KF, Chung MC, Erenberg CL, et al. Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: a systematic review and meta-analysis. Ann Surg, 2016, 264(1): 54-63.

1. Shida D, Tagawa K, Inada K, et al. Modified enhanced recovery after surgery (ERAS) protocols for patients with obstructive colorectal cancer. BMC Surg, 2017, 17(1): 18.
2. Ni X, Jia D, Chen Y, et al. Is the enhanced recovery after surgery (ERAS) program effective and safe in laparoscopic colorectal cancer surgery? A meta-analysis of randomized controlled trials. J Gastrointest Surg, 2019, 23(7): 1502-1512.
3. Engelman RM, Rousou JA, Flack JE 3rd, et al. Fast-track recovery of the coronary bypass patient. Ann Thorac Surg, 1994, 58(6): 1742-1746.
4. Zaouter C, Imbault J, Labrousse L, et al. Association of robotic totally endoscopic coronary artery bypass graft surgery associated with a preliminary cardiac enhanced recovery after surgery program: a retrospective analysis. J Cardiothorac Vasc Anesth, 2015, 29(6): 1489-1497.
5. Fleming IO, Garratt C, Guha R, et al. Aggregation of marginal gains in cardiac surgery: feasibility of a perioperative care bundle for enhanced recovery in cardiac surgical patients. J Cardiothorac Vasc Anesth, 2016, 30(3): 665-670.
6. Williams JB, McConnell G, Allender JE, et al. One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program. J Thorac Cardiovasc Surg, 2019, 157(5): 1881-1888.
7. Li M, Zhang J, Gan TJ, et al. Enhanced recovery after surgery pathway for patients undergoing cardiac surgery: a randomized clinical trial. Eur J Cardiothorac Surg, 2018, 54(3): 491-497.
8. Engelman DT, Ben Ali W, Williams JB, et al. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA Surg, 2019, 154(8): 755-766.
9. Narayan P, Kshirsagar SN, Mandal CK, et al. Preoperative glycosylated hemoglobin: a risk factor for patients undergoing coronary artery bypass. Ann Thorac Surg, 2017, 104(2): 606-612.
10. Lee EH, Kim WJ, Kim JY, et al. Effect of exogenous albumin on the incidence of postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass surgery with a preoperative albumin level of less than 4.0 g/dl. Anesthesiology, 2016, 124(5): 1001-1011.
11. Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: a systematic review of randomised controlled trials. J Clin Nurs, 2019, 28(17/18): 3096-3116.
12. Feguri GR, de Lima PRL, de Cerqueira Borges D, et al. Preoperative carbohydrate load and intraoperatively infused omega-3 polyunsaturated fatty acids positively impact nosocomial morbidity after coronary artery bypass grafting: a double-blind controlled randomized trial. Nutr J, 2017, 16(1): 24.
13. Ni R, Liu M, Huang S, et al. Effects of eHealth Interventions on quality of life and psychological outcomes in cardiac surgery patients: systematic review and meta-analysis. J Med Internet Res, 2022, 24(8): e40090.
14. Mutters NT, De Angelis G, Restuccia G, et al. Use of evidence-based recommendations in an antibiotic care bundle for the intensive care unit. Int J Antimicrob Agents, 2018, 51(1): 65-70.
15. Newland RF, Baker RA, Mazzone AL, et al. Rewarming temperature during cardiopulmonary bypass and acute kidney injury: a multicenter analysis. Ann Thorac Surg, 2016, 101(5): 1655-1662.
16. Allen KB, Thourani VH, Naka Y, et al. Rigid plate fixation versus wire cerclage: patient-reported and economic outcomes from a randomized trial. Ann Thorac Surg, 2018, 105(5): 1344-1350.
17. Allen KB, Thourani VH, Naka Y, et al. Randomized, multicenter trial comparing sternotomy closure with rigid plate fixation to wire cerclage. J Thorac Cardiovasc Surg, 2017, 153(4): 888-896.e1.
18. Myles PS, Smith JA, Forbes A, et al. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med, 2017, 376(2): 136-148.
19. Kim MH, Kim MS, Lee JH, et al. Intravenously administered lidocaine and magnesium during thyroid surgery in female patients for better quality of recovery after anesthesia. Anesth Analg, 2018, 127(3): 635-641.
20. Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth, 2017, 118(3): 317-334.
21. Salameh A, Greimann W, Vollroth M, et al. Lung protection in cardio-pulmonary bypass. J Physiol Pharmacol, 2017, 68(1): 99-116.
22. Arslantas MK, Kara HV, Tuncer BB, et al. Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections. J Thorac Cardiovasc Surg, 2015, 149(1): 314-320, 321.e1.
23. Güldner A, Kiss T, Serpa Neto A, et al. Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers. Anesthesiology, 2015, 123(3): 692-713.
24. Furnary AP, Wu Y. Eliminating the diabetic disadvantage: the portland diabetic project. Semin Thorac Cardiovasc Surg, 2006, 18(4): 302-308.
25. Greisen J, Nielsen DV, Sloth E, et al. High thoracic epidural analgesia decreases stress hyperglycemia and insulin need in cardiac surgery patients. Acta Anaesthesiol Scand, 2013, 57(2): 171-177.
26. Higgs M, Fernandez R. The effect of insulin therapy algorithms on blood glucose levels in patients following cardiac surgery: a systematic review. JBI Database System Rev Implement Rep, 2015, 13(5): 205-243.
27. Carli F, Baldini G. Fast-track surgery: it is time for the anesthesiologist to get involved!. Minerva Anestesiol, 2011, 77(2): 227-230.
28. Radbruch L, Glaeske G, Grond S, et al. Topical review on the abuse and misuse potential of tramadol and tilidine in Germany. Subst Abus, 2013, 34(3): 313-320.
29. Joshi SS, Jagadeesh AM. Efficacy of perioperative pregabalin in acute and chronic post-operative pain after off-pump coronary artery bypass surgery: a randomized, double-blind placebo controlled trial. Ann Card Anaesth, 2013, 16(3): 180-185.
30. Menda F, Köner O, Sayın M, et al. Effects of single-dose gabapentin on postoperative pain and morphine consumption after cardiac surgery. J Cardiothorac Vasc Anesth, 2010, 24(5): 808-813.
31. Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev, 2016, 3: CD005563.
32. Bergeron N, Dubois MJ, Dumont M, et al. Intensive care delirium screening checklist: evaluation of a new screening tool. Intensive Care Med, 2001, 27(5): 859-864.
33. Xu F, Zhang C, Liu C, et al. Relationship between first 24-h mean body temperature and clinical outcomes of post-cardiac surgery patients. Front Cardiovasc Med, 2021, 8: 746228.
34. Yu PJ, Cassiere HA, Kohn N, et al. Impact of postoperative hypothermia on outcomes in coronary artery bypass surgery patients. J Cardiothorac Vasc Anesth, 2017, 31(4): 1257-1261.
35. Grieshaber P, Heim N, Herzberg M, et al. Active chest tube clearance after cardiac surgery is associated with reduced reexploration rates. Ann Thorac Surg, 2018, 105(6): 1771-1777.
36. Sachdeva A, Dalton M, Lees T. Graduated compression stockings for prevention of deep vein thrombosis. Cochrane Database Syst Rev, 2018, 11(11): CD001484.
37. Ho KM, Bham E, Pavey W. Incidence of venous thromboembolism and benefits and risks of thromboprophylaxis after cardiac surgery: a systematic review and meta-analysis. J Am Heart Assoc, 2015, 4(10): e002652.
38. Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation, 2011, 124(23): e652-735.
39. Ge M, Wang Z, Chen T, et al. Risk factors for and outcomes of prolonged mechanical ventilation in patients received DeBakey type I aortic dissection repairment. J Thorac Dis, 2021, 13(2): 735-742.
40. Barker J, Martino R, Reichardt B, et al. Incidence and impact of dysphagia in patients receiving prolonged endotracheal intubation after cardiac surgery. Can J Surg, 2009, 52(2): 119-124.
41. Bianchi P, Constantine A, Costola G, et al. Ultra-fast-track extubation in adult congenital heart surgery. J Am Heart Assoc, 2021, 10(11): e020201.
42. Subramaniam K, DeAndrade DS, Mandell DR, et al. Predictors of operating room extubation in adult cardiac surgery. J Thorac Cardiovasc Surg, 2017, 154(5): 1656-1665.e2.
43. Kheterpal S, Vaughn MT, Dubovoy TZ, et al. Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis. Anesthesiology, 2020, 132(6): 1371-1381.
44. Mao H, Katz N, Ariyanon W, et al. Cardiac surgery-associated acute kidney injury. Blood Purif, 2014, 37(Suppl 2): 34-50.
45. O’Neal JB, Shaw AD, Billings FT 4th. Acute kidney injury following cardiac surgery: current understanding and future directions. Crit Care, 2016, 20(1): 187.
46. Scott NB, Turfrey DJ, Ray DA, et al. A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg, 2001, 93(3): 528-535.
47. Zarbock A, Kellum JA, Van Aken H, et al. Long-term effects of remote ischemic preconditioning on kidney function in high-risk cardiac surgery patients: follow-up results from the RenalRIP trial. Anesthesiology, 2017, 126(5): 787-798.
48. Kumar AB, Suneja M, Bayman EO, et al. Association between postoperative acute kidney injury and duration of cardiopulmonary bypass: a meta-analysis. J Cardiothorac Vasc Anesth, 2012, 26(1): 64-69.
49. Jia P, Teng J, Zou J, et al. miR-21 contributes to xenon-conferred amelioration of renal ischemia-reperfusion injury in mice. Anesthesiology, 2013, 119(3): 621-630.
50. Haase-Fielitz A, Haase M, Bellomo R, et al. Perioperative hemodynamic instability and fluid overload are associated with increasing acute kidney injury severity and worse outcome after cardiac surgery. Blood Purif, 2017, 43(4): 298-308.
51. Makaryus R, Miller TE, Gan TJ. Current concepts of fluid management in enhanced recovery pathways. Br J Anaesth, 2018, 120(2): 376-383.
52. Osawa EA, Rhodes A, Landoni G, et al. Effect of perioperative goal-directed hemodynamic resuscitation therapy on outcomes following cardiac surgery: a randomized clinical trial and systematic review. Crit Care Med, 2016, 44(4): 724-733.
53. Burgess LC, Wainwright TW. What is the evidence for early mobilisation in elective spine surgery? A narrative review. Healthcare (Basel), 2019, 7(3): 92.
54. Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg, 2018, 126(6): 1883-1895.
55. Willcutts KF, Chung MC, Erenberg CL, et al. Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: a systematic review and meta-analysis. Ann Surg, 2016, 264(1): 54-63.

Previous Article
Physiotherapy recommendations for coronavirus disease 2019 in intensive care units
Next Article
Research progress of exosomes in osteosarcoma

West China Medical Journal

Progress in the application of enhanced recovery after surgery concept in perioperative period of cardiac surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content