Journal of surgical oncology
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Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to demonstrate benefits when compared to a restrictive strategy within an optimized enhanced recovery protocol. The ideal monitors, hemodynamic goals, and fluid administration strategy are not well established but may be less important than rational application of thoughtful fluid management strategies.
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This paper reviews implementation of ERAS and its financial implications. Literature on clinical outcomes and financial implications were reviewed. ⋯ These improvements have major impacts on reducing the cost of care even when costs for implementation, and investment in time for personnel and training is accounted for. The conclusion is that ERAS is an excellent example of value based surgery.