[Enhanced recovery after surgery (ERAS®) in cardiac anesthesia]

Area of Science:

• Cardiology
• Surgical Innovation
• Perioperative Medicine

Background:

• Enhanced Recovery After Cardiac Surgery (ERACS) adapts Enhanced Recovery After Surgery (ERAS) protocols from other surgical fields.
• ERACS involves a multidisciplinary team and a shift in perioperative care culture.

Purpose of the Study:

• To describe the components and implementation of ERACS protocols in cardiac surgery.
• To highlight the benefits of prehabilitation, intraoperative management, and early recovery strategies.

Main Methods:

• Prehabilitation: improving physical, psychological, and nutritional status, including anemia treatment.
• Intraoperative management: infection reduction, rigid sternal closure, and goal-directed perioperative anesthesia.
• Early recovery: early extubation, mobilization, effective analgesia, and delirium management.

Main Results:

• Successful establishment of ERACS protocols reported, particularly in minimally invasive cardiac surgery.
• Demonstrates a structured approach to enhance patient recovery and autonomy post-cardiac surgery.

Conclusions:

• ERACS requires institutional adaptation and a cultural shift in perioperative care.
• Encourages development of specific ERACS protocols for diverse patient groups, including pediatric cardiac surgery and LVAD implantation.