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Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review.

Ljungqvist, O., de Boer, H.D., Balfour, A., Fawcett, W.J., Lobo, D.N., Nelson, G., Scott, M.J., Wainwright, T. and Demartines, N., 2021. Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review. JAMA Surgery, 156 (8), 775-784.

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DOI: 10.1001/jamasurg.2021.0586

Abstract

Importance: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion. Observations: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS. Conclusions and Relevance: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

Item Type:Article
ISSN:2168-6254
Additional Information:Error in Main Text JAMA Surg. Published online June 2, 2021 doi:10.1001/jamasurg.2021.2579 Related Articles The Original Investigation titled “Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review,” published online April 21, 2021, was corrected to fix an incorrect instance of the term corticosteroidal in the following sentence in the main text: “Recent studies report that selective relaxant binding agents provide a rapid and complete reversal of common corticosteroidal neuromuscular blocking agents without adverse effects found with other drugs.” The correct term is steroidal. This article was corrected online. References 1. Ljundqvist O, De Boer HD, Balfour A, et al. Opportunities and challenges for the next phase of enhanced recovery after surgery: a review.  JAMA Surg. Published online April 21, 2021.
Group:Faculty of Science & Technology
ID Code:35484
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:13 May 2021 13:56
Last Modified:06 Sep 2021 10:57

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