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Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery

Standard

Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery. / Kubitz, Jens C; Schulte-Uentrop, Leonie; Zoellner, Christian; Lemke, Melanie; Messner-Schmitt, Aurelie; Kalbacher, Daniel; Sill, Björn; Reichenspurner, Hermann; Koell, Benedikt; Girdauskas, Evaldas.

In: PLOS ONE, Vol. 15, No. 4, e0231378, 2020.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kubitz, JC, Schulte-Uentrop, L, Zoellner, C, Lemke, M, Messner-Schmitt, A, Kalbacher, D, Sill, B, Reichenspurner, H, Koell, B & Girdauskas, E 2020, 'Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery', PLOS ONE, vol. 15, no. 4, e0231378. https://doi.org/10.1371/journal.pone.0231378

APA

Kubitz, J. C., Schulte-Uentrop, L., Zoellner, C., Lemke, M., Messner-Schmitt, A., Kalbacher, D., Sill, B., Reichenspurner, H., Koell, B., & Girdauskas, E. (2020). Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery. PLOS ONE, 15(4), [e0231378]. https://doi.org/10.1371/journal.pone.0231378

Vancouver

Kubitz JC, Schulte-Uentrop L, Zoellner C, Lemke M, Messner-Schmitt A, Kalbacher D et al. Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery. PLOS ONE. 2020;15(4). e0231378. https://doi.org/10.1371/journal.pone.0231378

Bibtex

@article{7689627b587d441784d4283eb5cff7b5,
title = "Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery",
abstract = "Protocols for {"}Enhanced recovery after surgery (ERAS){"} are on the rise in different surgical disciplines and represent one of the most important recent advancements in perioperative medical care. In cardiac surgery, only few ERAS protocols have been described in the past. At University Heart Center Hamburg, Germany, we invented an ERAS protocol for patients undergoing minimally invasive cardiac valve surgery. In this retrospective single center study, we aimed to describe the implementation of our ERAS program and to evaluate the results of the first 50 consecutive patients. Our ERAS protocol was developed according to a modified Kern cycle by an expert group, literature search, protocol creation and pilot implementation in the clinical practice. Data of the first 50 consecutive patients undergoing minimally invasive cardiac valve surgery were analysed retrospectively. The key features of our multidisciplinary ERAS protocol are physiotherapeutic prehabilitation, minimally invasive valve surgery techniques, modified cardiopulmonary bypass management, fast-track anaesthesia with on- table extubation and early mobilisation. A total of 50 consecutive patients (mean age of 51.9±11.9 years, mean STS score of 0.6±0.3) underwent minimally-invasive mitral or aortic valve surgery. The adherence to the ERAS protocol was high and neither protocol related complications nor in-hospital mortality occurred. 12% of the patients developed postoperative atrial fibrillation, postoperative delirium emerged in two patients and reintubation was required in one patient. Intensive care unit stay was 14.0±7.4 hours and total hospital stay 6.2±2.9 days. Our ERAS protocol is feasible and safe in minimally-invasive cardiac surgery setting and has a clear potential to improve patients outcome.",
keywords = "Adult, Aortic Valve/surgery, Atrial Fibrillation/diagnosis, Enhanced Recovery After Surgery, Female, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Minimally Invasive Surgical Procedures/adverse effects, Mitral Valve/surgery, Pain/etiology, Postoperative Complications, Retrospective Studies, Treatment Adherence and Compliance, Treatment Outcome",
author = "Kubitz, {Jens C} and Leonie Schulte-Uentrop and Christian Zoellner and Melanie Lemke and Aurelie Messner-Schmitt and Daniel Kalbacher and Bj{\"o}rn Sill and Hermann Reichenspurner and Benedikt Koell and Evaldas Girdauskas",
year = "2020",
doi = "10.1371/journal.pone.0231378",
language = "English",
volume = "15",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "4",

}

RIS

TY - JOUR

T1 - Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery

AU - Kubitz, Jens C

AU - Schulte-Uentrop, Leonie

AU - Zoellner, Christian

AU - Lemke, Melanie

AU - Messner-Schmitt, Aurelie

AU - Kalbacher, Daniel

AU - Sill, Björn

AU - Reichenspurner, Hermann

AU - Koell, Benedikt

AU - Girdauskas, Evaldas

PY - 2020

Y1 - 2020

N2 - Protocols for "Enhanced recovery after surgery (ERAS)" are on the rise in different surgical disciplines and represent one of the most important recent advancements in perioperative medical care. In cardiac surgery, only few ERAS protocols have been described in the past. At University Heart Center Hamburg, Germany, we invented an ERAS protocol for patients undergoing minimally invasive cardiac valve surgery. In this retrospective single center study, we aimed to describe the implementation of our ERAS program and to evaluate the results of the first 50 consecutive patients. Our ERAS protocol was developed according to a modified Kern cycle by an expert group, literature search, protocol creation and pilot implementation in the clinical practice. Data of the first 50 consecutive patients undergoing minimally invasive cardiac valve surgery were analysed retrospectively. The key features of our multidisciplinary ERAS protocol are physiotherapeutic prehabilitation, minimally invasive valve surgery techniques, modified cardiopulmonary bypass management, fast-track anaesthesia with on- table extubation and early mobilisation. A total of 50 consecutive patients (mean age of 51.9±11.9 years, mean STS score of 0.6±0.3) underwent minimally-invasive mitral or aortic valve surgery. The adherence to the ERAS protocol was high and neither protocol related complications nor in-hospital mortality occurred. 12% of the patients developed postoperative atrial fibrillation, postoperative delirium emerged in two patients and reintubation was required in one patient. Intensive care unit stay was 14.0±7.4 hours and total hospital stay 6.2±2.9 days. Our ERAS protocol is feasible and safe in minimally-invasive cardiac surgery setting and has a clear potential to improve patients outcome.

AB - Protocols for "Enhanced recovery after surgery (ERAS)" are on the rise in different surgical disciplines and represent one of the most important recent advancements in perioperative medical care. In cardiac surgery, only few ERAS protocols have been described in the past. At University Heart Center Hamburg, Germany, we invented an ERAS protocol for patients undergoing minimally invasive cardiac valve surgery. In this retrospective single center study, we aimed to describe the implementation of our ERAS program and to evaluate the results of the first 50 consecutive patients. Our ERAS protocol was developed according to a modified Kern cycle by an expert group, literature search, protocol creation and pilot implementation in the clinical practice. Data of the first 50 consecutive patients undergoing minimally invasive cardiac valve surgery were analysed retrospectively. The key features of our multidisciplinary ERAS protocol are physiotherapeutic prehabilitation, minimally invasive valve surgery techniques, modified cardiopulmonary bypass management, fast-track anaesthesia with on- table extubation and early mobilisation. A total of 50 consecutive patients (mean age of 51.9±11.9 years, mean STS score of 0.6±0.3) underwent minimally-invasive mitral or aortic valve surgery. The adherence to the ERAS protocol was high and neither protocol related complications nor in-hospital mortality occurred. 12% of the patients developed postoperative atrial fibrillation, postoperative delirium emerged in two patients and reintubation was required in one patient. Intensive care unit stay was 14.0±7.4 hours and total hospital stay 6.2±2.9 days. Our ERAS protocol is feasible and safe in minimally-invasive cardiac surgery setting and has a clear potential to improve patients outcome.

KW - Adult

KW - Aortic Valve/surgery

KW - Atrial Fibrillation/diagnosis

KW - Enhanced Recovery After Surgery

KW - Female

KW - Humans

KW - Intensive Care Units

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Minimally Invasive Surgical Procedures/adverse effects

KW - Mitral Valve/surgery

KW - Pain/etiology

KW - Postoperative Complications

KW - Retrospective Studies

KW - Treatment Adherence and Compliance

KW - Treatment Outcome

U2 - 10.1371/journal.pone.0231378

DO - 10.1371/journal.pone.0231378

M3 - SCORING: Journal article

C2 - 32271849

VL - 15

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 4

M1 - e0231378

ER -