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How We Would Use Enhanced Recovery After Cardiac Surgery: What We Would Do for Ourselves During the Perioperative
Crosby Culp1, Michael W Manning2
1Division of General, Vascular and Transplant Anesthesia, Division of Cardiothoracic Anesthesia, Duke University, Durham, NC.
Abstract:
Enhanced Recovery After Cardiac Surgery (ERACS) programs have grown from their humble beginnings as a "fast-track recovery" pathway that was first described in 1994 and have now evolved into patient-centered, multidisciplinary, multimodal, comprehensive, evidence-based bundles that standardize care and minimize variability throughout the perioperative period. Here, we use a model case, one familiar to most cardiac anesthesiologists, to describe how we would like to be managed using ERACS pathways. These are the same pathways and interventions we use almost daily in our own practices. We highlight the key pathway elements that we would want and describe the rationale behind their use, across the perioperative period, beginning with the initial consultation for surgery to the day of surgery, and into the intensive care unit and floor recovery, onward to hospital discharge.
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