Enhanced Recovery after Cardiac Surgery (ERAS): Redefining Patient Care for the 21st Century

Key Insights from the University Hospital Zurich Symposium

The symposium at the University Hospital Zurich highlighted recent advances in Enhanced Recovery After Surgery (ERAS) protocols in cardiac surgery and the importance of their continued evolution to optimise perioperative care.

Hosted¹/Chaired² by

• Prof. Dr. Omer Dzemali¹
• PD Dr. David Niederseer MHBA²
• Prof. Dr. Bettina Pfannmüller²
• PD Dr. Hector Rodriguez²

Summary of Key Insights on ERAS Protocols in Cardiac Surgery

The speakers focused on how prehabilitation, minimally invasive surgical approaches, optimal drain management, and rehabilitation all contribute to reducing both hospital length of stay and complication rates.

Key perioperative elements to improve outcomes: early extubation, early mobilisation, opioid-sparing multimodal regional analgesics, physiotherapy, nutritional support, and early drain removal.

• Optimal drain management is crucial, with retained blood syndrome (RBS) being a common complication. Digital chest drainage technology and active tube clearance (ATC) technology have significantly improved patient outcomes, reducing postoperative complications, reexploration rates, and lower mortality rates.
• Certain elements included in clinical trials have yet to be implemented in ERAS protocols, and these are vital for continued advancement in patient care. Frailty assessments in perioperative care are fundamental for high-risk patients. Delirium prevention strategies are recommended.
• Supervised exercise programs, nutritional support, and improving physical fitness and mental health before surgery all lead to enhanced clinical effectiveness.
• Economic studies are warranted to justify the cost-benefit of perioperative programs.

Read the full report here.

Presenters and Lectures:

• Sonia Matter-Ensner, MD, Zurich/CH

  Postoperative Management in the ERAS Model: What to Consider?

• David Niederseer, MD, PhD, Davos/CH

  ERAS Approach: Applicable to All Cardiac Surgery Patients? 

• PD Dr. Jurij Kalisnik, Klagenfurt/AUT

  Retained Blood Syndrome: What is It?

• Prof. Dr. Theodor Fischlein, Nuremberg/GER

  Post-op Drainage Management: Is It Important, and What Do We Know About It?

• Prof. Dr. Nestoras Papadopoulos, Zurich/CH

  MICS and How Proactive Chest Drain Management Could Help.

• Stak Dushaj, MD, Zurich/CH

  Posterior Pericardiotomy in Cardiac Surgery: An Alternative to Conventional Drain Management?