Controversies in enhanced recovery after cardiac surgery

Advances in cardiac surgical operative techniques and myocardial protection have dramatically improved outcomes in the past two decades. An unfortunate and unintended consequence is that 80% of the preventable morbidity and mortality following cardiac surgery now originates outside of the operating...

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Bibliographic Details
Published in:Perioperative medicine (London) 2022-04, Vol.11 (1), p.19-19, Article 19
Main Authors: Shaw, Andrew D, Guinn, Nicole R, Brown, Jessica K, Arora, Rakesh C, Lobdell, Kevin W, Grant, Michael C, Gan, Tong J, Engelman, Daniel T
Format: Article
Language:English
Subjects:
Acute kidney injury
Anemia
Associations, institutions, etc
Biomarkers
Blood
Clinical outcomes
Delirium
Dexmedetomidine
Enhanced recovery after surgery
Evidence-based medicine
Health aspects
Heart surgery
Hemoglobin
Hospital costs
Iron
Kidney diseases
Mortality
Opioid analgesia reduction
Opioids
Ostomy
Patient blood management
Patients
Quality management
Recovery (Medical)
Risk assessment
Societies
Thromboembolism
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Summary:Advances in cardiac surgical operative techniques and myocardial protection have dramatically improved outcomes in the past two decades. An unfortunate and unintended consequence is that 80% of the preventable morbidity and mortality following cardiac surgery now originates outside of the operating room. Our hope is that a renewed emphasis on evidence-based best practice and standardized perioperative care will reduce overall morbidity and mortality and improve patient-centric care. The Perioperative Quality Initiative (POQI) and Enhanced Recovery After Surgery-Cardiac Society (ERAS® Cardiac) have identified significant evidence gaps in perioperative medicine related to cardiac surgery, defined as areas in which there is significant controversy about how best to manage patients. These five areas of focus include patient blood management, goal-directed therapy, acute kidney injury, opioid analgesic reduction, and delirium.
ISSN:2047-0525
2047-0525
DOI:10.1186/s13741-022-00250-7