[ERAS Implementation in Thoracic Surgery].
Jens NeudeckerMarco Nicolas AndreasAina LaskJulia StrauchmannAron ElsnerJens-Carsten RückertTomasz DziodzioPublished in: Zentralblatt fur Chirurgie (2024)
This manuscript provides an overview of the principles and requirements for implementing the ERAS program in thoracic surgery.The ERAS program optimises perioperative management of elective lung resection procedures and is based on the ERAS Guidelines for Thoracic Surgery of the ERAS Society. The clinical measures are described as in the current literature, with a focus on postoperative outcome. There are currently 45 enhanced recovery items covering four perioperative phases: from the prehospital admission phase (patient education, screening and treatment of potential risk factors such as anaemia, malnutrition, cessation of nicotine or alcohol abuse, prehabilitation, carbohydrate loading) to the immediate preoperative phase (shortened fasting period, non-sedating premedication, prophylaxis of PONV and thromboembolic complications), the intraoperative measures (antibiotic prophylaxis, standardised anaesthesia, normothermia, targeted fluid therapy, minimally invasive surgery, avoidance of catheters and probes) through to the postoperative measures (early mobilisation, early nutrition, removal of a urinary catheter, hyperglycaemia control). Most of these measures are based on scientific studies, with a high level of evidence and aim to reduce general postoperative complications.The ERAS program is an optimised perioperative treatment approach aiming to improve the postoperative recovery in patients after elective lung resection by reducing the overall complication rates and overall morbidity.
Keyphrases
- patients undergoing
- thoracic surgery
- quality improvement
- risk factors
- healthcare
- cardiac surgery
- end stage renal disease
- primary care
- newly diagnosed
- ejection fraction
- cardiac arrest
- systematic review
- physical activity
- peritoneal dialysis
- type diabetes
- acute kidney injury
- blood pressure
- atrial fibrillation
- insulin resistance
- prognostic factors
- drug delivery
- adipose tissue
- climate change
- bone marrow
- mesenchymal stem cells