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Cited by 13Enhanced Recovery After SurgeryHemodynamic Monitoring and TherapyNausea and vomiting management

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Efficacy of enhanced recovery programmes for cardiac surgery: a systematic review and meta-analysis

Open access
Hoogma, Danny F., Meeusen, Immele, Coppens, Steve, Verbrugghe, Peter, van den Eynde, Jef, Engelman, Daniel T., Grant, Michael C., Stoppe, Christian, Rex, Steffen·2025·British Journal of Anaesthesia
DOI 10.1016/j.bja.2025.03.019PMC PMC12597454
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Abstract

Background The terms fast-track (FT) and enhanced recovery after surgery (ERAS) are often mistakenly used interchangeably. Fast-track cardiac anaesthesia focuses on perioperative strategies, whereas ERAS (or enhanced recovery programme [ERP]) encompasses a wider range of strategies designed to enhance overall recovery. Evidence is needed to demonstrate the additive value of ERP above FT in cardiac surgery. We conducted a meta-analysis to investigate the comparative efficacy of ERP and FT programmes in cardiac surgery. Methods We systematically searched PubMed, Embase, and Web of Science for randomised trials and prospective observational trials investigating ERP or FT programmes in cardiac surgery (up to November 16, 2024). Following PRISMA guidelines, two reviewers independently selected studies, extracted data, and assessed risk of bias. Data were pooled using a random-effects model. The primary efficacy outcome was hospital length of stay (LOS). Results A total of 6368 articles were identified, of which 18 studies, with 2625 patients, were included. Compared with control, a significant reduction in hospital LOS (mean difference [95% confidence interval (CI)] -1.40 days [-2.19 to -0.61], P=0.001), ICU LOS (-13.22 h [-21.75 to -4.68], P=0.006), and ventilation time (-4.68 h [-7.85 to -1.52], P=0.008) was identified when ERP or FT programmes were implemented. ERP demonstrated an additive value above FT for hospital LOS (2.11 days [-3.52 to 0.71] vs -0.30 days [-0.88 to 0.27], respectively; P=0.003). Conclusions In cardiac surgery, ERP can reduce LOS in the ICU and hospital and ventilatory time. Moreover, it is suggested that ERPs, including preoperative, intraoperative, and postoperative interventions, are preferred above only intraoperative FT strategies. Systematic review protocol PROSPERO (CRD42022382409).

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Metadata

Authors
Hoogma, D. F., Meeusen, I., Coppens, S., Verbrugghe, P., van den Eynde, J., Engelman, D. T., Grant, M. C., Stoppe, C., & Rex, S.
Affiliations
  • Universitair Ziekenhuis Leuven (BE)
  • KU Leuven (BE)
  • Baystate Medical Center (US)
  • Johns Hopkins University (US)
  • Universitätsklinikum Würzburg (DE)
Corresponding author
Hoogma, Danny F.
ORCID
Venue
British Journal of Anaesthesia
Publisher
Elsevier BV
Published
2025-07
Volume
135
Issue
1
Pages
31-39
ISSN
0007-0912 (ISSN-L)
DOI
10.1016/j.bja.2025.03.019
PMC
PMC12597454
OpenAlex
W4409811936
Cited by
13
References
3
Citations by year
2026: 11 · 2025: 2
FWCI
2.46
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Anaesthesia (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed (publishedVersion)
  • Lirias (submittedVersion)
Funders
KU Leuven
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Surgery › Nausea and vomiting management
Keywords
enhanced recovery after surgery, cardiac surgery, length of hospital stay, ICU length of stay, mechanical ventilation duration, perioperative care, postoperative recovery
MeSH terms
Enhanced Recovery After Surgery, Cardiac Surgical Procedures, Humans, Length of Stay, Randomized Controlled Trials as Topic, Perioperative Care

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