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Pediatric enhanced recovery after surgery (ERAS): Advancements and outcomes in the last 5 years
Megan A Brockel1, Vidya T Raman2
1Department of Anesthesiology, University of Colorado, Children's Hospital of Colorado, Aurora, Colorado.
Insights
Enhanced Recovery After Surgery (ERAS) has advanced pediatric care, significantly reducing complications and hospital stays. Upcoming multicenter trials and new guidelines will further shape pediatric ERAS protocols.
Area of Science:
- Pediatric Surgery
- Perioperative Care
- Evidence-Based Medicine
Background:
- Enhanced Recovery After Surgery (ERAS) has been established in adult care for decades.
- Pediatric ERAS implementation began approximately 10 years ago, showing initial promise.
- The multidisciplinary approach of ERAS is gaining traction in pediatric settings.
Purpose of the Study:
- To review recent advancements in pediatric Enhanced Recovery After Surgery (ERAS).
- To assess the outcomes and impact of evidence-based ERAS pathways in children.
- To cover all phases of pediatric perioperative care within the ERAS framework.
Main Methods:
- Review of recent literature on pediatric ERAS.
- Analysis of outcomes from single-center studies and multicenter trials.
- Examination of newly published ERAS Society recommendations for pediatric patients.
Main Results:
- Single-center studies demonstrate ERAS reduces complications and length of stay in pediatric patients.
- The first ERAS Society guidelines for pediatric care were released in 2024.
- Two major multicenter pediatric ERAS trials (PURSUE and ENRICH-US) have completed enrollment, with results anticipated in 2025.
Conclusions:
- Pediatric ERAS has shown significant progress and improved patient outcomes in the last five years.
- Future pediatric ERAS practice will be guided by multicenter trial results.
- Development of further rigorous ERAS Society recommendations for children is expected.
Purpose Of Review:
The aim is to describe recent advances in pediatric enhanced recovery after surgery (ERAS) in all phases of care as well as the outcomes and impact of recent evidenced-based pathways in pediatric patients.
Recent Findings:
While profoundly impactful in the care of adult patients for nearly 3 decades, ERAS had a slower start in pediatric care that began approximately 10 years ago. Early outcomes were promising, and the multidisciplinary approach to perioperative care has gained momentum, with recent single-center studies of ERAS for pediatric patients showing reductions in both complications and length of stay. The first ERAS Society recommendations for pediatric patients were published in 2024, and two multicenter trials of pediatric ERAS, Pediatric urology recovery after surgery endeavor and ENhanced Recvovery in CHildren Undergoing Surgery (ENRICH-US), have completed enrollment and are expected to publish results in 2025.
Summary:
ERAS in pediatric practice has made great strides in the past 5 years and has led to improved outcomes for young patients. Multicenter trial outcomes and the development of additional rigorous ERAS Society recommendations for children will guide future care.
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