• Yasser Ali Kamal and Ahmed Hassanein.
• Department of Cardiothoracic Surgery, Minia University, El-Minya, Egypt.
• Interact Cardiovasc Thorac Surg. 2020 May 1; 30 (5): 706-710.

AbstractA best evidence topic was constructed according to a structured protocol. The question addressed was whether the application of an enhanced recovery protocol or pathway improves patient outcomes after cardiac surgery. A total of 3091 papers were found using the reported search. Finally, 12 papers represented the best available evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Six studies referred to enhanced recovery protocol as fast track (FT) and another 6 studies referred to it as enhanced recovery after surgery (ERAS). Significant differences from conventional care were reported for time to extubation or intubation time in 4 studies (3 FT, 1 ERAS), duration of intensive care unit stay in 6 studies (4 FT, 2 ERAS), length of hospital stay (LOS) in 8 studies (5 FT, 3 ERAS), cost in 5 studies (4 FT, 1 ERAS), pain scores in 2 studies (2 ERAS) and opioid use in 3 studies (3 ERAS). We conclude that FT or ERAS improve postoperative outcomes including length of stay and pain control, without increasing morbidity, mortality or readmission. However, there is a need for prospective studies and standardized protocols.© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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