Abstract
BackgroundEnhanced Recovery After Surgery (ERAS®) Society guidelines integrate evidence-based practices into multimodal care pathways that have improved outcomes in multiple adult surgical specialties. There are currently no pediatric ERAS® Society guidelines. We created an ERAS® guideline designed to enhance quality of care in neonatal intestinal resection surgery.MethodsA multidisciplinary guideline generation group defined the scope, population, and guideline topics. Systematic reviews were supplemented by targeted searching and expert identification to identify 3514 publications that were screened to develop and support recommendations. Final recommendations were determined through consensus and were assessed for evidence quality and recommendation strength. Parental input was attained throughout the process.ResultsFinal recommendations ranged from communication strategies to antibiotic use. Topics with poor-quality and conflicting evidence were eliminated. Several recommendations were combined. The quality of supporting evidence was variable. Seventeen final recommendations are included in the proposed guideline.DiscussionWe have developed a comprehensive, evidence-based ERAS guideline for neonates undergoing intestinal resection surgery. This guideline, and its creation process, provides a foundation for future ERAS guideline development and can ultimately lead to improved perioperative care across a variety of pediatric surgical specialties.
Highlights
Enhanced Recovery After Surgery (ERASÒ) guidelines are designed to deliver standardized, evidence-based, collaborative care throughout the surgical journey [1,2,3,4,5,6]
We have developed a comprehensive, evidence-based ERAS guideline for neonates undergoing intestinal resection surgery
Mucous fistula refeeding can augment absorption of enteral nutrition required for healing and growth
Summary
Enhanced Recovery After Surgery (ERASÒ) guidelines are designed to deliver standardized, evidence-based, collaborative care throughout the surgical journey [1,2,3,4,5,6]. ERASÒ implementation has reduced complications, length of stay (LOS), and costs, while improving patient and staff satisfaction [5,6,7]. Despite these successes, there are few pediatric ERASÒ studies and no ERASÒ Society pediatric guidelines. Surgery (ERASÒ) Society guidelines integrate evidence-based practices into multimodal care pathways that have improved outcomes in multiple adult surgical specialties.
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