Enhanced Recovery After Cardiac Surgery: Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Membership Survey.

OBJECTIVES: To assess the implementation rates within 2 society memberships of enhanced recovery elements for cardiac surgery. DESIGN: Survey on individual and institutional practice patterns of perioperative recommendations from the Enhanced Recovery After Surgery (ERAS) Cardiac Society. SETTING: International, multi-institutional; academic, public, and private. PARTICIPANTS: Members of the Society of Cardiovascular Anesthesiologists (SCA) and the American Society of Anesthesiologists (ASA). INTERVENTION: Anonymous electronic survey with 45 questions on 30 enhanced recovery elements. PRIMARY OUTCOME: Quantifying degrees of implementation of the ERAS recommendations into high (>70%), intermediate (25-69%), or low (<25%). MEASUREMENTS AND MAIN RESULTS: Data were summarized with descriptive statistics and margins of error. A total of 399 members responded (SCA, n = 138; ASA, n = 261). Reported rates of implementation vary between elements. Elements reported as highly implemented include limiting nil per os status, postoperative nausea and vomiting prevention, early extubation, and multimodal analgesia. Those reported as intermediate implementations include goal-directed therapy, regional analgesia, and prevention of acute kidney injury. Low implemented elements include the use of digital technology, prehabilitation, and standardized nutritional support. CONCLUSIONS: While a low response rate and other biases limit generalizable conclusions, the subset of SCA and ASA members who responded report implementing enhanced recovery elements heterogeneously. Complex, costly, transdisciplinary elements seem to be applied to a lesser degree. These results identify potential areas of perioperative care that could be candidates for further research, education, and advocacy.

Duke Scholars

Author Annemarie Thompson Anesthesiology, Cardiothoracic