J Anesth Perioper Med. 2014;1(1):50-56. https://doi.org/10.24015/ebcmed.japm.2014.0008

Enhanced Recovery After Surgery (ERAS) Protocols and Perioperative Lung Protection

Jeffrey Huang

From Anesthesiologists of Greater Orlando, Winter Park, Florida, USA.

Correspondence to Dr. Jeffrey Huang at jeffhuangmd@gmail.com.

EBCMED ID: ebcmed.japm.2014.0008 DOI: 10.24015/ebcmed.japm.2014.0008


Abstract

Aim of review
Patients are at risk for lung injury in the perioperative period. The enhanced recovery after surgery (ERAS) has been associated with a reduction in duration of hospital stay, readmissions, and reoperations, together with decreased mortality and morbidity, improved pain control, better cost containment, and improved patient satisfaction.

Method
we review the recent literatures on ERAS for prevention of perioperative pulmonary complications (PPCs).

Recent findings
Current ERAS protocols include >20 elements. Many elements in ERAS protocol can prevent perioperative lung injury, therefore reduce complications, enhance recovery, reduce length of stay, and lower the cost. Preadmission information, education and counseling, preoperative optimization, prophylaxis against thromboembolism, standard anesthetic protocol, laparoscopy and modifications of surgical access, perioperative fluid management, postoperative analgesia, and early mobilization impact directly on perioperative lung protection. Minimization of preoperative fasting, early resumption of oral intake, avoidance of bowel preparation can reduce the volume of intravenous fluid requirement, indirectly prevent lung injury.

Summary
ERAS elements can prevent lung injury, reduce complications, enhance recovery, reduce length of stay, and lower the cost.

Article Type
Review Article

Declaration of Interests
No potential conflict of interest relevant to this review was reported.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.