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Consensus-based eligibility criteria and component definitions for neonatal and infant enhanced recovery pathway: a
Johanna M Borst1,2, Mehul V Raval1,2, Mallory N Perez1,2
1Northwestern Quality Improvement, Research & Education in Surgery (NQUIRES), Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Objective:
The 2020 Enhanced Recovery After Surgery (ERAS®) guidelines for neonatal intestinal surgery have not been widely implemented due to unclear eligibility criteria and poorly defined components. We sought to establish consensus-based eligibility criteria and definitions for a revised enhanced recovery pathway (ERP).
Study Design:
We conducted two modified Delphi processes to establish eligibility criteria and define the components by engaging stakeholders including surgeons, anesthesiologists, neonatologists, nurses, dietitians, quality improvement specialists, and parents/caregivers at six pediatric hospitals. Eligibility criteria were established through two survey rounds; components were defined through two survey rounds and one focus group.
Results:
Forty-five stakeholders participated (82% response). Consensus supported inclusion of infants born ≥32 weeks' gestation or ≥1.5 kg undergoing elective/semi-urgent gastrointestinal surgery and defined 19 components, with 10 initially accepted and 9 revised.
Conclusions:
The consensus-based Delphi process established eligibility and defined the components to facilitate implementation and adoption of an ERP for neonates and infants undergoing gastrointestinal surgery.
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