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Published on: January 17, 2011
[Fast tracking in pediatric surgery]
1Chirurgische Klinik, Sektion Kinderchirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany. stefan.holland-cunz@med.uni-heidelberg.de
Insights
Fast track protocols are safe and feasible for pediatric surgery, but rigid application is not suitable for neonates. Individualized care and optimized perioperative strategies are key for successful pediatric fast track surgical pathways.
Area of Science:
- Pediatric Surgery
- Enhanced Recovery After Surgery (ERAS) Protocols
Context:
- Fast track protocols, also known as Enhanced Recovery After Surgery (ERAS), are increasingly implemented in various surgical fields.
- Pediatric surgical procedures, especially those involving neonates and infants, present unique challenges for perioperative care.
- Existing workflows in pediatric surgery often aim for shortened hospital stays.
Purpose:
- To evaluate the feasibility, safety, and outcomes of fast track protocols in pediatric surgery.
- To identify necessary adjustments for optimizing fast track protocols in very young patients.
- To determine the suitability of rigid fast track concepts for neonatal and infant surgical procedures.
Summary:
- Published data indicate that fast track protocols are feasible and safe for pediatric surgery, with low complication and readmission rates.
- Rigid application of fast track protocols is not beneficial for neonates and infants, who require specialized postoperative care.
- Optimizations for pediatric fast track protocols include perioperative adjustments, reduced fasting times, and the use of novel analgesics.
- Customizing protocols to individual patient needs is crucial, particularly for pediatric populations.
Impact:
- Fast track protocols can be safely applied to pediatric surgical procedures, leading to favorable outcomes.
- The findings highlight the need for tailored fast track approaches in pediatric surgery, especially for the youngest patients.
- This research informs the development of evidence-based, individualized fast track protocols to improve pediatric surgical care and patient recovery.
Abstract:
Fast track protocols are justified for several pediatric surgical procedures. Particular operations on neonates and babies require specialized postoperative care. In these very young patients, no benefit can be expected from rigid fast track concepts. Many workflows in pediatric surgery have already been optimized with a view toward very short hospital stay. The published experiences with fast track protocols in pediatric surgery show that the method is feasible and safe. Complication and readmission rates are very low. Perioperative adjustments, shorter fasting periods, and the use of new analgetics are desirable in pediatric fast track protocols. Particularly for children, customizing protocols to the individual patients' requirements must be guaranteed.
