Abstract
Enhanced Recovery After Surgery (ERAS) is an evidence-based, patient-centered strategy founded in multidisciplinary care where team members emphasize patient optimization and engagement while consistently delivering key protocol components. Measurable improvements in surgical outcomes occur when ERAS principles are applied. These include reduced complications, improved early mobility, and enteral feeding, and quicker return to full function. Patients engage and safely reach their clearly defined discharge goals leading to high patient satisfaction, decreased length of stay, and reduced cost of care. Protocol compliance is fundamental to improved ERAS outcomes. Regular audits by the ERAS team to review data, and monitor protocol compliance, help implementation and improve quality. Pediatric-specific ERAS protocols demonstrate improved patient outcomes. Pediatric surgeons should adopt ERAS principles into their practice.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Further Reading
Brady M, Kinn S, Ness V, et al. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009;(4):Cd005285.
Brindle ME, Heiss K, Scott MJ, et al. Embracing change: the era for pediatric ERAS is here. Pediatr Surg Int. 2019;35(6):631–4.
Flynn JM, Striano BM, Muhly WT, et al. A dedicated pediatric spine deformity team significantly reduces surgical time and cost. JBJS. 2018;100(18):1574–80.
George JA, Koka R, Gan TJ, et al. Review of the enhanced recovery pathway for children: perioperative anesthetic considerations. Can J Anesth. 2018;65(5):569–77.
Gillis C, Gill M, Marlett N, et al. Patients as partners in enhanced recovery after surgery: a qualitative patient-led study. BMJ Open. 2017;7(6):e017002.
Gramlich LM, Sheppard CE, Wasylak T, et al. Implementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a health system. Implement Sci. 2017;12(1):1–17.
Han DS, Brockel MA, Boxley PJ, et al. Enhanced recovery after surgery and anesthetic outcomes in pediatric reconstructive urologic surgery. Pediatr Surg Int. 2021;37(1):1–9.
Heiss KF, Raval MV. Patient engagement to enhance recovery for children undergoing surgery. Semin Pediatr Surg. 2018;27(2):86–91.
Hush SE, Chen JT, Brady CM, et al. Implementation of a modified enhanced recovery protocol in cleft palate repairs. J Craniofac Surg. 2019;30(7):2154–8.
Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.
Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292–8.
Maessen J, Dejong C, Hausel J, et al. A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J surg. 2007;94(2):224–31.
McLeod RS, Aarts M-A, Chung F, et al. Development of an enhanced recovery after surgery guideline and implementation strategy based on the knowledge-to-action cycle. Ann Surg. 2015;262(6):1016–25.
Nygren J, Thorell A, Ljungqvist O. Preoperative oral carbohydrate therapy. Curr Opin Anaesth. 2015;28(3):364–9.
Pearsall EA, McLeod RS. Enhanced recovery after surgery: implementation strategies, barriers and facilitators. Surg Clin No Am. 2018;98(6):1201–10.
Reismann M, von Kampen M, Laupichler B, et al. Fast-track surgery in infants and children. J Pediatr Surg. 2007;42(1):234–8.
Short HL, Heiss KF, Burch K, Travers C, Edney J, Venable C, Raval MV. Implementation of an enhanced recovery protocol in pediatric colorectal surgery. J Pediatr Surg. 2018;53(4):688–92.
Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014;8:CD009161.
Smith AE, Heiss K, Childress KJ. Enhanced recovery after surgery in pediatric and adolescent gynecology: a pilot study. J Pediatr Adolesc Gynecol. 2020;33(4):403–9.
Vacek J, Davis T, Many BT, et al. A baseline assessment of enhanced recovery protocol implementation at pediatric surgery practices performing inflammatory bowel disease operations. J Pediatr Surg. 2020;55(10):1996–2006.
Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29(4):434–40.
Vrecenak JD, Mattei P. Fast-track management is safe and effective after bowel resection in children with Crohn’s disease. J Pediatr Surg. 2014;49(1):99–102.
Yeh A, Butler G, Strotmeyer S, et al. ERAS protocol for pediatric laparoscopic cholecystectomy promotes safe and early discharge. J Pediatr Surg. 2020;55(1):96–100.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Zamora, I.J., Ghani, M.O.A., Heiss, K. (2022). Enhanced Recovery After Surgery Protocols (ERAS): The Next Generation of Perioperative Quality Improvement, Safety, and Innovation. In: Mattei, P. (eds) Fundamentals of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-07524-7_7
Download citation
DOI: https://doi.org/10.1007/978-3-031-07524-7_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-07523-0
Online ISBN: 978-3-031-07524-7
eBook Packages: MedicineMedicine (R0)