Prehabilitation, enhanced recovery after surgery, or both? A narrative review.
Br J Anaesth
; 128(3): 434-448, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-35012741
ABSTRACT
This narrative review presents a biological rationale and evidence to describe how the preoperative condition of the patient contributes to postoperative morbidity. Any preoperative condition that prevents a patient from tolerating the physiological stress of surgery (e.g. poor cardiopulmonary reserve, sarcopaenia), impairs the stress response (e.g. malnutrition, frailty), and/or augments the catabolic response to stress (e.g. insulin resistance) is a risk factor for poor surgical outcomes. Prehabilitation interventions that include exercise, nutrition, and psychosocial components can be applied before surgery to strengthen physiological reserve and enhance functional capacity, which, in turn, supports recovery through attaining surgical resilience. Prehabilitation complements Enhanced Recovery After Surgery (ERAS) care to achieve optimal patient outcomes because recovery is not a passive process and it begins preoperatively.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pós-Operatórios
/
Cuidados Pré-Operatórios
Tipo de estudo:
Risk_factors_studies
Limite:
Animals
/
Humans
Idioma:
En
Revista:
Br J Anaesth
Ano de publicação:
2022
Tipo de documento:
Article