Implementation of enhanced recovery in cardiac surgery: An experimental study with the control group

• Published in: Asian cardiovascular & thoracic annals Vol. 31; no. 2; pp. 88 - 96
• Main Authors: Hendy, Ayman, DiQuinzo, Claudio, O'Reilly, Mark, Hendy, Abdelaziz, Vician, Michael, Theriault, Chris, Chedrawy, Edgar, Hirsch, Gregory, Aliter, Hashem
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2023
• Subjects: Analgesics, Opioid - therapeutic use; Cardiac Surgical Procedures - adverse effects; Control Groups; Humans; Intensive Care Units; Length of Stay; Morphine Derivatives; Original; Pain, Postoperative - diagnosis; Pain, Postoperative - etiology; Pain, Postoperative - prevention & control; perioperative management; Enhanced recovery after surgery; cardiac surgery
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/02184923221138504

Introduction The Enhanced Recovery After Cardiac Surgery protocol is the most recent addition to cardiac treatment. In this paper, we aimed to test the safety and viability of this protocol in our hospital to improve our standard of care. Methods This study was conducted as an experimental study with a historical control at the Maritime Heart Center, Halifax, Nova Scotia, Canada. In order to quantify the success of this protocol, we measured the postoperative Length of Hospital Stay and three intensive care unit variables: time to extubation, time to ambulation, and opioid consumption. In the study, 100 patients were in the Enhanced Recovery After Cardiac Surgery group, and 103 patients were used as historic controls-selected by strenuous chart review and selection criteria. Results The primary outcome (Length of Hospital Stay) was reduced from a mean of 8.88 ± 3.50 days in the control group to a mean of 5.13 ± 1.34 days in the Enhanced Recovery After Cardiac Surgery group (p < 0.001). Likewise, we observed a significant reduction in intensive care unit variables: time to extubation was reduced from 10.54 ± 7.83 h in the control group to 6.69 ± 1.63 in the Enhanced Recovery After Cardiac Surgery group (p < 0.01), and time to ambulation was reduced from 36.27 ± 35.21 h in the control group to 9.78 ± 2.03 in the Enhanced Recovery After Cardiac Surgery group (p < 0.01) and opioid consumption was reduced from 50.58 ± 11.93 milligram morphine equivalent in the control group to 11.58 ± 4.43 milligram morphine equivalent in the Enhanced Recovery After Cardiac Surgery group (p < 0.01). Conclusion Enhanced Recovery After Cardiac Surgery protocols were seamlessly integrated into selected cardiac surgical patients, contingent on a high level of interprofessional communication and collaboration.