TY - JOUR
T1 - Cardiac Enhanced Recovery After Surgery
T2 - Early Outcomes in a Community Setting
AU - Salenger, Rawn
AU - Holmes, Sari D.
AU - Rea, Amanda
AU - Yeh, Jennifer
AU - Knott, Kate
AU - Born, Rachel
AU - Boss, Michael J.
AU - Barr, Linda F.
N1 - Funding Information:
The authors thank Rebecca Sandler, MS, RN; Elizabeth Holderness, ACNP; and Eileen Skaarer, MS, RN, for their hard work in the success of the Cardiac ERAS Program and valued contributions helping to make this project possible. This study was supported by an unrestricted grant from the University of Maryland St. Joseph Medical Center Foundation.
Funding Information:
The authors thank Rebecca Sandler, MS, RN; Elizabeth Holderness, ACNP; and Eileen Skaarer, MS, RN, for their hard work in the success of the Cardiac ERAS Program and valued contributions helping to make this project possible. This study was supported by an unrestricted grant from the University of Maryland St. Joseph Medical Center Foundation.
Publisher Copyright:
© 2022 The Society of Thoracic Surgeons
PY - 2022/6
Y1 - 2022/6
N2 - Background: 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. Methods: 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. Results: 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. Conclusions: Cardiac ERAS significantly decreased opioid use, nausea, and lightheadedness and improved functional outcome for cardiac surgical patients in a community hospital.
AB - Background: 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. Methods: 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. Results: 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. Conclusions: Cardiac ERAS significantly decreased opioid use, nausea, and lightheadedness and improved functional outcome for cardiac surgical patients in a community hospital.
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U2 - 10.1016/j.athoracsur.2021.06.072
DO - 10.1016/j.athoracsur.2021.06.072
M3 - Article
C2 - 34352198
AN - SCOPUS:85119520068
SN - 0003-4975
VL - 113
SP - 2008
EP - 2017
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -