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Enhanced surgical recovery programmes in the ICU 

Enhanced surgical recovery programmes in the ICU
Chapter:
Enhanced surgical recovery programmes in the ICU
Author(s):

Michael J. Scott

and Monty Mythen

DOI:
10.1093/med/9780199600830.003.0364
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date: 30 November 2020

Enhanced recovery programmes (ERPs) are evidence-based care pathways starting from the point of patient referral right through the peri-operative period until discharge home. The ERP aims to reduce surgical stress and enhance post-operative physiological function with resulting early return of enteral diet and mobilization to improve outcomes. There are 20 evidence-based elements, many of which are delivered by a multidisciplinary team. Many elements support a treatment intervention, but some aim to avoid an intervention, which can negatively impact on recovery. An ERP with good compliance has been shown to reduce length of stay and medical complications. Minimal access surgery, high quality analgesia, and goal-directed fluid therapy are key factors ensuring optimal outcomes. There has been successful adoption and transfer of enhanced recovery principles into many surgical specialties. There is wide variation in the use of critical care within ERPs depending on local policy and patient risk factors.

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