What does Cardiac ERAS recommend?

 
 
 

Clinical impact and cost savings of evidence-based protocols for perioperative care in cardiac surgery

Haemodynamic instability during and after cardiac surgery occurs frequently, and is associated with AKI and other complications after surgery.1-9 

 

There is now a wealth of best practice guidelines to address this.10-12

 

To address haemodynamic instability and associated complications, Enhanced Recovery After Surgery (ERAS) protocol recommends goal-directed therapy.10 A recent meta-analysis of the ERAS protocols concluded that overall the ERAS protocol accelerated postoperative rehabilitation and reduced costs.13

 

In this short video, Professor Marjan Jahangiri of St George’s Hospital explains how ERAS is creating an opportunity for cardiac surgery to really improve morbidity, complications and overall quality of life. 

 
 

Brand new guidance from ERAS, in a joint consensus report with the PeriOperative Quality Initiative (POQI)

Highlights that due to a lack of reliable or effective treatment options for cardiac surgery associated AKI, prevention and early detection are paramount.10 

 

In addition, both the Acute Disease Quality Initiative Group (ADQI) and Kidney Disease: Improving Global Outcomes (KDIGO) recommend a proactive approach to managing haemodynamic instability:11,12 

“Advanced hemodynamic monitoring of cardiovascular function is recommended for progressive or severe AKI or hemodynamically unstable patients”11 

ADQI 2018

 

“We suggest using protocol-based management of hemodynamic and oxygenation parameters to prevent development or worsening of AKI in high-risk patients in the perioperative setting”12

KDIGO Clinical Practice Guidelines 2012

 

Would you like to discuss how Edwards solutions can support a Cardiac ERAS protocol in your hospital? 

Speak to a representative today
 

Discover advanced haemodynamic monitoring solutions

Acumen Hypotension Prediction Index (HPI) software

 

Acumen HPI software is effective in detecting haemodynamic instability and substantially reducing the duration of intraoperative hypotension. 

Medical device for professional use. For a listing of indications, contraindications, precautions, warnings, and potential adverse events, please refer to the Instructions for Use (consult eifu.edwards.com where applicable).

 

References

  1. Zarbock A & Engelman DT. J Thorac Cardiovasc Surg 2020;159:1878-1879.
  2. Maheshwari A, et al. Br J Anaesthesia 2017;119:40–49.
  3. Sun LY, et al. Anesthesiology 2018; 129:440-7.
  4. Smeltz AM, et al. J Cardiothorac Vasc Anesth 2018;32:1214-1224.
  5. Liu YL, et al. Nephrol Dial Transplant 2009;24:504–511.
  6. de la Hoz MA, et al. Anesthesiology 2022;136: 927–939.
  7. Molnar Z, et al. Br J Anaesth 2020;125:419-423.
  8. Vos JJ & Scheeren TW. Indian J Anaesth 2019;63:877-85.
  9. Haase-Fielitz A, et al. Blood Purif 2017;43:298–308. 
  10. Brown JK et al. J Cardiothoracic & Vascular Anesthesia. May 2023.
  11. Nadim MK et al. J Am Heart Assoc 2018 Jun 5;7(11):e008834.
  12. Kellum JA and Lameire N. Critical Care 12:204(2013).
  13. Shen W et al. PLoS One 2021;16(5):e0251476. 

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