Initial experience introducing an enhanced recovery program in congenital cardiac surgery

Area of Science:

• Pediatric Cardiac Surgery
• Enhanced Recovery After Surgery (ERAS) Protocols
• Perioperative Care Optimization

Background:

• Congenital heart surgery traditionally involves prolonged recovery periods.
• Enhanced Recovery After Surgery (ERAS) programs have shown success in various surgical fields.
• Implementing ERAS in pediatric congenital heart surgery requires tailored evidence-based interventions.

Purpose of the Study:

• To evaluate the impact of a novel ERAS program on functional recovery after congenital heart surgery.
• To assess the effect of the ERAS program on length of stay and complication rates.
• To analyze the initial implementation experience and adherence to ERAS protocols.

Main Methods:

• A cohort of patients undergoing congenital heart surgery were enrolled in an ERAS program.
• Key ERAS components included early extubation and multimodal pain management.
• Outcomes were compared to a historical pre-ERAS cohort using propensity matching.

Main Results:

• The ERAS program was associated with significantly reduced mechanical ventilation time (7.6 vs. 8.2 hours) and intensive care unit length of stay (1.12 vs. 1.28 days).
• Early extubation (<8 hours) was achieved in 54% of ERAS patients.
• No increase in complications, readmissions, or reinterventions was observed in the ERAS group.

Conclusions:

• The initial implementation of an ERAS program in pediatric congenital heart surgery shows promise in accelerating recovery.
• Adherence to all ERAS components requires further optimization.
• Multidisciplinary collaboration and continuous quality monitoring are crucial for ERAS program success.