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Impact of Limited Enhanced Recovery Pathway for Cardiac Surgery: A Single-Institution Experience.
- Source :
- Journal of Cardiothoracic & Vascular Anesthesia; Jan2024, Vol. 38 Issue 1, p175-182, 8p
- Publication Year :
- 2024
-
Abstract
- Enhanced recovery pathway (ERP) refers to extensive multidisciplinary, evidence-based pathways used to facilitate recovery after surgery. The authors assessed the impact that limited ERP protocols had on outcomes in patients undergoing cardiac surgery at their institution. A retrospective cohort study. This study was a single-institution study conducted at a university hospital. Patients undergoing open adult cardiac surgery. Enhanced recovery pathways limited to preoperative, intraoperative, and postoperative management of pain, atrial fibrillation prevention, and nutrition optimization were implemented. A total of 1,058 patients were included in this study. There were 374 patients in each pre- and post-ERP cohort after propensity matching, with no significant baseline differences between the 2 cohorts. Compared to the matched patients in the pre-ERP group, patients in the post-ERP group had decreased total ventilation hours (6.8 v 7.8, p = 0.006), less use of postoperative opioid analgesics as determined by total morphine milligram equivalent (32.5 v 47.5, p < 0.001), and a decreased rate of postoperative atrial fibrillation (23.3% v 30.5%, p = 0.032). Post-ERP patients also experienced less subjective pain and postoperative nausea and drowsiness as compared to their matched pre-ERP cohorts. Limited ERP implementation resulted in significantly improved perioperative outcomes. Patients additionally experienced less postoperative pain despite decreased opioid use. Implementation of ERP, even in a limited format, is a promising approach to improving outcomes in patients undergoing cardiac surgery. [Display omitted] [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10530770
- Volume :
- 38
- Issue :
- 1
- Database :
- Supplemental Index
- Journal :
- Journal of Cardiothoracic & Vascular Anesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 174338738
- Full Text :
- https://doi.org/10.1053/j.jvca.2023.10.021