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Enhanced Recovery (Fast-Track) After Cardiac and Vascular Surgery

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Enhanced Recovery after Surgery

Abstract

Enhanced recovery after surgery (ERAS®) is an enhanced postoperative recovery program based on evidence-based medicine introduced by the European Society for Clinical Nutrition and Metabolism in 2005. Many reports have been shown that this program is useful not only in general surgery but also in cardiac and vascular surgery. The goals of this management are reducing operative stress, early restarting of meal consumption, early starting of postoperative rehabilitation, shortening the length of postoperative hospital stay, reducing medical costs, reducing patient anxiety perioperatively and encouraging the patient’s volition to recover, and securing safety and satisfactory results. Although only minimally invasive surgery has been continuously developing in Japan, this management is not yet widely used and conventional management remains standard in many institutions. In this chapter, we introduce the many elements of ERAS® management for cardiac and vascular surgery divided into the preoperative, intraoperative, and postoperative periods, according to our experiences and past reports.

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References

  1. Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery society: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24:466–77.

    Article  CAS  PubMed  Google Scholar 

  2. Cotton P. Fast-track improves CABG outcomes. JAMA. 1993;270:2023.

    Article  CAS  PubMed  Google Scholar 

  3. Celkan MA, Ustunsoy H, Daglar B, Kazaz H, Kocoglu H. Readmission and mortality in patients undergoing off-pump coronary artery bypass surgery with fast-track recovery protocol. Heart Vessel. 2005;20:251–5.

    Article  Google Scholar 

  4. Haanschoten MC, van Straten AH, ter Woorst JF, Stepaniak PS, van der Meer AD, van Zundert AA, et al. Fast-track practice in cardiac surgery: results and predictors of outcome. Interact Cardiovasc Thorac Surg. 2012;15:989–94.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Moon MC, Abdoh A, Hamilton GA, Lindsay WG, Duke PC, Pascoe EA, et al. Safety and efficacy of fast track in patients undergoing coronary artery bypass surgery. J Card Surg. 2001;16:319–26.

    Article  CAS  PubMed  Google Scholar 

  6. Papadopoulos N, El-Sayed Ahmad A, Thudt M, Fichtlscherer S, Meybohm P, Reyher C, et al. Successful fast track protocol implementation for patients undergoing transapical transcatheter aortic valve implantation. J Cardiothorac Surg. 2016;11:55.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tatsuishi W, Kohri T, Kodera K, Asano R, Kataoka G, Kubota S, et al. Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm. Surg Today. 2012;42:1195–200.

    Article  PubMed  Google Scholar 

  8. Shimizu T, Miyata G, Goto H, Hashimoto M, Akamatsu D, Miyama N, et al. The efficacy of perioperative care based on ERAS protocol and ESSENSE project for the patients who underwent abdominal aortic aneurysm repair. Jpn J Surg Metab Nutr. 2016;50:63–9.

    Article  Google Scholar 

  9. Sanders G, Mercer SJ, Saeb-Parsey K, Akhavani MA, Hosie KB, Lambert AW. Randomized clinical trial of intravenous fluid replacement during bowel preparation for surgery. Br J Surg. 2001;88:1363–5.

    Article  CAS  PubMed  Google Scholar 

  10. Tsimopoulou I, Pasquali S, Howard R, Desai A, Gourevitch D, Tolosa I, et al. Psychological prehabilitation before cancer surgery: a systematic review. Ann Surg Oncol. 2015;22:4117–23.

    Article  PubMed  Google Scholar 

  11. Gillis C, Li C, Lee L, Awasthi R, Augustin B, Gamsa A, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121:937–47.

    Article  PubMed  Google Scholar 

  12. Bellamy MC. Wet, dry or something else? Br J Anaesth. 2006;97:755–7.

    Article  CAS  PubMed  Google Scholar 

  13. Goepfert MS, Reuter DA, Akyol D, Lamm P, Kilger E, Goetz AE. Goal-directed fluid management reduces vasopressor and catecholamine use in cardiac surgery patients. Intensive Care Med. 2007;33:96–103.

    Article  PubMed  Google Scholar 

  14. Borracci RA, Ochoa G, Ingino CA, Lebus JM, Grimaldi SV, Gambetta MX. Routine operation theatre extubation after cardiac surgery in the elderly. Interact Cardiovasc Thorac Surg. 2016;22:627–32.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Abdallah FW, Adham AM, Chan VW, Kanazi GE. Analgesic benefits of preincisional transversus abdominis plane block for abdominal aortic aneurysm repair. J Cardiothorac Vasc Anesth. 2013;27:536–8.

    Article  CAS  PubMed  Google Scholar 

  16. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334:1209–15.

    Article  CAS  PubMed  Google Scholar 

  17. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: a randomized clinical trial. JAMA. 1997;277:1127–34.

    Article  CAS  PubMed  Google Scholar 

  18. Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–92.

    Article  CAS  PubMed  Google Scholar 

  19. Mohamed AD. Ephedrine-dexamethasone combination reduces postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. J Anesth. 2007;18. https://print.ispub.com/api/0/ispub-article/5662.

  20. Wallenborn J, Gelbrich G, Bulst D, Behrends K, Wallenborn H, Rohrbach A, et al. Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial. BMJ. 2006;333:324.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350:2441–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. White PF. Prevention of postoperative nausea and vomiting--a multimodal solution to a persistent problem. N Engl J Med. 2004;350:2511–2.

    Article  CAS  PubMed  Google Scholar 

  23. Tatsuishi W, Adachi H, Murata M, Tomono J, Okonogi S, Okada S, et al. Relationship between postoperative hyperglycemia and atrial fibrillation after coronary artery bypass graft surgery. Circ J. 2015;79:112–8.

    Article  PubMed  Google Scholar 

  24. Samuels LE, Holmes EC, Samuels FL. Selective use of amiodarone and early cardioversion for postoperative atrial fibrillation. Ann Thorac Surg. 2005;79:113–6.

    Article  PubMed  Google Scholar 

  25. Lazar HL, McDonnell M, Chipkin SR, Furnary AP, Engelman RM, Sadhu AR, Society of Thoracic Surgeons Blood Glucose Guideline Task Force, et al. The Society of Thoracic Surgeons practice guideline series: blood glucose management during adult cardiac surgery. Ann Thorac Surg. 2009;87:663–9.

    Article  PubMed  Google Scholar 

  26. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, The Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20:250–78.

    Article  CAS  PubMed  Google Scholar 

  27. Podore PC, Throop EB. Infrarenal aortic surgery with a 3-day hospital stay: a report on success with a clinical pathway. J Vasc Surg. 1999;29:787–92.

    Article  CAS  PubMed  Google Scholar 

  28. Christensen T, Kehlet H. Postoperative fatigue. World J Surg. 1993;17:220–5.

    Article  CAS  PubMed  Google Scholar 

  29. Takagi K, Teshima H, Arinaga K, Yoshikawa K, Hori H, Kashikie H, et al. Gum chewing enhances recovery of bowel function following transperitoneal abdominal aortic surgery. Surg Today. 2012;42:759–64.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Tokyo Women’s Medical University, Tokyo, Japan

    Wataru Tatsuishi, Kiyoharu Nakano, Sayaka Kubota, Ryota Asano, Atsuhiko Sato & Go Kataoka

Authors
  1. Wataru Tatsuishi
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  2. Kiyoharu Nakano
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  3. Sayaka Kubota
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  4. Ryota Asano
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  5. Atsuhiko Sato
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  6. Go Kataoka
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Corresponding author

Correspondence to Wataru Tatsuishi .

Editor information

Editors and Affiliations

  1. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

    Ryoji Fukushima

  2. Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan

    Masaki Kaibori

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© 2018 Springer Nature Singapore Pte Ltd.

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Tatsuishi, W., Nakano, K., Kubota, S., Asano, R., Sato, A., Kataoka, G. (2018). Enhanced Recovery (Fast-Track) After Cardiac and Vascular Surgery. In: Fukushima, R., Kaibori, M. (eds) Enhanced Recovery after Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-10-6796-9_13

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  • DOI: https://doi.org/10.1007/978-981-10-6796-9_13

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6795-2

  • Online ISBN: 978-981-10-6796-9

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