Title: Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS).
Free Full text: https://academic.oup.com/ejcts/article/55/1/91/5124324
Published: Eur J Cardiothorac Surg. 2019 Jan 1;55(1):91-115.
Authors: Timothy J.P. Batchelora, Neil J. Rasburn, Etienne Abdelnour-Berchtold, Alessandro Brunelli, Robert J. Cerfolio, Michel Gonzalez, Olle Ljungqvist, Ren´eH. Petersen, Wanda M.Popescu, Peter D. Slinger and Babu Naidu
Development of the Consensus:
A systematic review of meta-analyses, randomized controlled trials, large non-randomized studies and reviews was conducted for each protocol element. Smaller prospective and retrospective cohort studies were considered only when higher-level evidence was unavailable. The quality of the evidence base was graded by the authors and used to form consensus recommendations for each topic. Development of these recommendations was endorsed by the Enhanced Recovery after Surgery Society and the European Society for Thoracic Surgery.
Recommendations were developed for a total of 45 enhanced recovery items covering topics related to pre-admission, admission, intraoperative care and postoperative care. Most are based on good-quality studies. In some instances, good-quality data were not available, and subsequent recommendations are generic or based on data extrapolated from other specialties. In other cases, no recommendation can currently be made because either equipoise exists or there is a lack of available evidence. Recommendations are based not only on the quality of the evidence but also on the balance between desirable and undesirable effects.
Links to Comments and Reactions on the EACTA’s Social Media Platforms
Do you think that the consensus statement will change your local policy on the perioperative management of lung surgery?
Do you think that the ERAS result in an improved patients’ outcomes?
Do you think that the ERAS could be extended to patients undergoing major vascular surgery (e.g. open aortic surgery)?
Do you routinely administer a combination of acetaminophen and NSAIDs in all patients undergoing thoracic surgery (ERAS; high evidence and strong recommendation)?
Are you routinely using regional anaesthesia for lung surgery?
If you routinely use regional anaesthesia for lung surgery, which blockade are you frequently using?
How to define the lung-protective strategies?