Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Abstract

Background Enhanced Recovery After Surgery (ERAS Ò) 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 Ò Society guidelines. We created an ERAS Ò guideline designed to enhance quality of care in neonatal intestinal resection surgery. Methods A 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. Results Final 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. Discussion We 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. Mary E. Brindle and Caraline McDiarmid are co-first authors.

The Pertinent Literature of Enhanced Recovery after Surgery Programs: A Bibliometric Approach

“…In this bibliometric analysis, 8539 ERAS-related studies were identified for the period 1994−2019, with the annual global publication showing significant growth since 2014. This condition might be affected by various guidelines published by the ERAS Society in recent years [ 1 , 9 , 10 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Eighteen languages were published in ERAS-related studies.…”

“…Scientific publication is the core of discipline development and scholarly communication, and the creation of clinical practice guidelines also depends on the strong evidence from the literature [ 8 , 9 , 10 ]. Bibliometric analysis is a method for discovering the characteristics of a research subject to understand the current status and trend through the literature, and it is commonly used in the medical field [ 11 , 12 , 13 , 14 , 15 ].…”

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

“…Human milk is recommended by the Enhanced Recovery After Surgery Society as first choice of nutrition in the newborn after surgery [ 166 ]. In the absence of human milk, it is still debated the best type of formula milk to use.…”

Expanding enhanced recovery protocols for cardiac surgery to include the patient voice: a scoping review protocol

“…An area that could be viewed for improvement in the development of the protocol was the lack of central involvement from patients and their caregivers, a key stakeholder group. Notably, of the 20 current published ERP guidance documents (across many surgical subspecialties), only one involved caregivers as partners in the process used to arrive at the provided recommendations [12].…”