Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

• DOI: 10.1007/s00268-021-05994-9
• Publication Date: 2021-03-06T22:02:35Z
• Authors: Carol J. Peden; Geeta Aggarwal; Robert J. Aitken; Iain D. Anderson; Nicolai Bang Foss; Zara Cooper; Jugdeep K. Dhesi; W. Brenton French; Michael C. Grant; Folke Hammarqvist; Sarah P. Hare; Joaquim M. Havens; Daniel N. Holena; Martin Hübner; Jeniffer S. Kim; Nicholas P. Lees; Olle Ljungqvist; Dileep N. Lobo; Shahin Mohseni; Carlos A. Ordoñez; Nial Quiney; Richard D. Urman; Elizabeth Wick; Christopher L. Wu; Tonia Young‐Fadok; Michael Scott
• Keywords: Vascular surgery; Guideline; Evidence-Based Medicine; Cardiothoracic surgery; Preoperative care; Grading (engineering)

Abstract Background Enhanced Recovery After Surgery (ERAS) protocols reduce length of stay, complications and costs for a large number elective surgical procedures. A similar, structured approach appears to improve outcomes, including mortality, patients undergoing high‐risk emergency general surgery, specifically laparotomy. These are the first consensus guidelines optimal care these using an ERAS approach. Methods Experts in aspects management patient were invited contribute by International ERAS® Society. Pubmed, Cochrane, Embase, MEDLINE database searches on English language publications performed elements relevant specific topics. Studies each item selected with particular attention randomized controlled trials, systematic reviews, meta‐analyses cohort studies, reviewed graded Grading Recommendations, Assessment, Development Evaluation (GRADE) system. Recommendations made best level evidence, or extrapolation from studies non‐emergency when appropriate. The Delphi method was used validate final recommendations. guideline has been divided into two parts: Part 1—Preoperative Care 2—Intraoperative Postoperative management. This paper provides 1. Results Twelve components preoperative considered. Consensus reached after three rounds. Conclusions based available evidence Initial is particularly important sepsis physiological derangement. should be outcomes patients.