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Enhanced recovery after surgery in children: Promising, evidence-based multidisciplinary care
Kyle O Rove1, John C Edney2, Megan A Brockel3
1Division of Pediatric Urology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA.
Insights
Enhanced recovery after surgery (ERAS) protocols improve outcomes in adults, but pediatric data is limited. This review explores ERAS in children, comparing it to traditional care and suggesting implementation strategies.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Surgical Outcomes
Background:
- Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care pathway.
- ERAS programs have demonstrated reduced length of stay (LOS) and complications in adult surgical patients.
- Limited research exists on ERAS implementation and outcomes in pediatric populations.
Purpose of the Study:
- To review the history and components of ERAS protocols.
- To examine the existing evidence for ERAS in both adult and pediatric surgical patients.
- To compare ERAS with the traditional Postoperative Surgical Home (PSH) model and propose future directions for pediatric ERAS.
Main Methods:
- Educational review of existing literature on ERAS protocols.
- Analysis of adult and pediatric studies on ERAS implementation and outcomes.
- Comparative analysis of ERAS and PSH models.
Main Results:
- ERAS protocols are well-established in adult surgery, showing significant benefits.
- Pediatric evidence for ERAS is sparse, indicating a need for further research and implementation.
- ERAS offers a structured approach to optimize surgical patient care.
Conclusions:
- ERAS principles are applicable to pediatric surgery, potentially improving patient recovery.
- Further research and tailored implementation strategies are crucial for pediatric ERAS success.
- Transitioning from traditional care to ERAS in children requires careful planning and evidence-based approaches.
Abstract:
Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children.
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