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1.
Rev. argent. cir ; 113(2): 149-158, jun. 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365469

ABSTRACT

RESUMEN En este artículo se revisan los principios de los protocolos ERAS de recuperación optimizada después de la cirugía y sus raíces en las ciencias médicas, y cómo el grupo de estudio ERAS Study Group y posteriormente ERAS® Society (www.erassociety.org) los crearon. Los protocolos ERAS representan una fórmula para elaborar vías de atención perioperatoria basadas en la literatura médica para los pacientes quirúrgicos. Se realiza una revisión de la literatura médica por parte de grupos de expertos que reúnen los elementos asistenciales con datos científicos que demuestran los efectos beneficiosos para la recuperación. Al reunir múltiples elementos de atención que han demostrado mejorar los resultados, se crea una guía a partir de la cual se puede establecer una vía de atención. Posteriormente, la eficacia de la guía se pone a prueba en la práctica clínica evaluando del cumplimiento de los elementos de atención de la guía relacionados con los desenlaces clínicos relevantes. Muchas recomendaciones de ERAS® Society han demostrado mejorar los resultados en términos de complicaciones y recuperación y alta hospitalaria. Cada vez hay más informes que muestran una asociación entre el mejor cumplimiento de las recomendaciones y la supervivencia a largo plazo después de la cirugía. Otro aspecto de la base científica de los protocolos ERAS son los estudios que sugieren que los efectos clínicos se consiguen modulando varios aspectos de las respuestas al estrés quirúrgico.


ABSTRACT In this paper the principles of Enhanced Recovery After Surgery (ERAS) and how it is rooted in the medical sciences is reviewed and how ERAS has been developed by the ERAS Study Group and later by the ERAS®Society (www.erassociety.org). ERAS represents a formula for developing perioperative care pathways for patients undergoing surgery based on the medical literature. Expert groups review the medical literature and assembles care elements that have scientific data to show beneficial effects for recovery. By assembling multiple care elements all shown to improve outcomes, a Guideline is created from which a care pathway can be built. The Guideline is later tested in clinical practice to evaluate its effectiveness by studying compliance to the guideline care elements related to key clinical outcomes. Several ERAS®Society Guidelines have been proven to improve outcomes both with regard to complications and in hospital recovery and discharge. A growing number of reports are showing an association between improved compliance to guidelines and long term survival after surgery. Another aspect of the science behind ERAS are studies suggesting that the clinical effects are achieved by modulating various aspects of the surgical stress responses.

2.
Rev Col Bras Cir ; 47: e20202525, 2020 Jun 03.
Article in English | MEDLINE | ID: mdl-32578819

ABSTRACT

The shortage of hospital beds and changes in the payment model have promoted an increased attention and financing of programs that focus on perioperative care efficiency in. Latin America. In this paper, Enhanced Recovery After Surgery (ERAS) programs developed by the ERAS® Society will be discussed. The implementation and use of ERAS®Society Guidelines consistently demonstrated a reduction in postoperative complications, hospital stay and costs. In the current paper, the definition of ERAS programs, their core elements, and the results of their implementation and regional developments are presented with special focus on Latin America.


Subject(s)
Enhanced Recovery After Surgery , Perioperative Care , Humans , Latin America , Length of Stay , Postoperative Complications
3.
Rev. Col. Bras. Cir ; 47: e20202525, 2020. graf
Article in English | LILACS | ID: biblio-1136602

ABSTRACT

The shortage of hospital beds and changes in the payment model have promoted an increased attention and financing of programs that focus on perioperative care efficiency in. Latin America. In this paper, Enhanced Recovery After Surgery (ERAS) programs developed by the ERAS® Society will be discussed. The implementation and use of ERAS®Society Guidelines consistently demonstrated a reduction in postoperative complications, hospital stay and costs. In the current paper, the definition of ERAS programs, their core elements, and the results of their implementation and regional developments are presented with special focus on Latin America.


Subject(s)
Humans , Perioperative Care , Enhanced Recovery After Surgery , Postoperative Complications , Latin America , Length of Stay
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