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Preparing enhanced recovery after surgery for implementation in pediatric populations

Ira L Leeds1, Emily F Boss2, Jessica A George3

  • 1Department of Surgery, The Johns Hopkins Hospital and Johns Hopkins University School of Medicine, 600 North Wolfe Street, Blalock 618, Baltimore, MD 21287.

Journal of Pediatric Surgery
|September 25, 2016
PubMed

Insights

Enhanced recovery after surgery (ERAS) programs improve adult surgical outcomes but are underutilized in pediatric care. This study details a new pediatric colorectal ERAS program and discusses implementation challenges.

Area of Science:

  • Perioperative medicine
  • Pediatric surgery
  • Clinical pathways

Background:

  • Enhanced Recovery After Surgery (ERAS) programs standardize evidence-based practices to improve surgical outcomes and efficiency in adults.
  • ERAS programs have demonstrated reductions in length of stay, complication rates, and enhanced patient satisfaction in adult populations.
  • Widespread adaptation of ERAS programs for pediatric surgery remains limited due to a lack of direct evidence and varying acceptance among providers and families.

Discussion:

  • Implementation of ERAS programs in pediatric colorectal surgery requires careful consideration of evidence translation from adult studies.
  • Addressing provider and family acceptance is crucial for successful integration of ERAS principles in pediatric care.
  • Standardizing perioperative care through ERAS pathways can potentially optimize outcomes for pediatric surgical patients.

Key Insights:

  • Limited direct evidence currently exists for adapting adult ERAS pathways to pediatric surgery.
  • A newly implemented ERAS program for pediatric colorectal surgery is described, highlighting initial experiences.
  • Challenges include the translatability of adult evidence and varying stakeholder acceptance.

Outlook:

  • Further research is needed to establish robust evidence for pediatric ERAS pathways.
  • Broader implementation requires addressing specific pediatric needs and stakeholder engagement.
  • Optimizing pediatric surgical care through standardized pathways like ERAS holds significant potential.

Keywords:
Enhanced recovery after surgeryErasImplementationPediatricSurgery

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