Opportunities and Challenges for the Next Phase of Enhanced Recovery after Surgery: A Review

Authors: Ljungqvist, O., De Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T.W. and Demartines, N.

Journal: JAMA Surgery

Volume: 156

Issue: 8

Pages: 775-784

eISSN: 2168-6262

ISSN: 2168-6254

DOI: 10.1001/jamasurg.2021.0586

Abstract:

Importance: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion. Observations: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS. Conclusions and Relevance: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems..

https://eprints.bournemouth.ac.uk/35484/

Source: Scopus

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review.

Authors: Ljungqvist, O., de Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T.W. and Demartines, N.

Journal: JAMA Surg

Volume: 156

Issue: 8

Pages: 775-784

eISSN: 2168-6262

DOI: 10.1001/jamasurg.2021.0586

Abstract:

IMPORTANCE: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion. OBSERVATIONS: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS. CONCLUSIONS AND RELEVANCE: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

https://eprints.bournemouth.ac.uk/35484/

Source: PubMed

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery A Review

Authors: Ljungqvist, O., de Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T.W. and Demartines, N.

Journal: JAMA SURGERY

Volume: 156

Issue: 8

Pages: 775-784

eISSN: 2168-6262

ISSN: 2168-6254

DOI: 10.1001/jamasurg.2021.0586

https://eprints.bournemouth.ac.uk/35484/

Source: Web of Science (Lite)

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review.

Authors: Ljungqvist, O., de Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T.W. and Demartines, N.

Journal: JAMA surgery

Volume: 156

Issue: 8

Pages: 775-784

eISSN: 2168-6262

ISSN: 2168-6254

DOI: 10.1001/jamasurg.2021.0586

Abstract:

Importance

Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion.

Observations

Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS.

Conclusions and relevance

To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

https://eprints.bournemouth.ac.uk/35484/

Source: Europe PubMed Central

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review.

Authors: Ljungqvist, O., de Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T. and Demartines, N.

Journal: JAMA Surgery

Volume: 156

Issue: 8

Pages: 775-784

ISSN: 2168-6254

Abstract:

Importance: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion. Observations: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS. Conclusions and Relevance: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

https://eprints.bournemouth.ac.uk/35484/

Source: BURO EPrints