Enhanced recovery after cardiac surgery protocols. Systematic review and metaanalysis of observational studies

Introduction: The systematic review associated by meta-analysis is the methodological component allowing summarizes all the scientific information about the effects of therapeutics methods. To avoid bias some author recommends it in randomized controlled trial, but sometimes there are not enough articles of this kind as a present topic.
Objective: We performed this study to evaluate the benefits of enhanced recovery program in the perioperative evolution of patients undergoing cardiac surgery.
Method: The observational studies published between January 2015 and July 2019 was included. The systematic review was made using recommended guidelines from the Cochrane collaborations management system. In the metaanalysis for dichotomous outcomes the odds ratios and relative risk were calculated and for continuous outcomes the means differences was evaluated. Also the heterogeneity between the studies was analyzed and the sensibility analysis was made. Results: 11 studies, enrolling 4 122 patients (group ERACS= 1 236, group Control = 2 886) patients were included. The implementation of enhanced recovery program reduces the risk of perioperative complication, hospital readmission 30 days before the discharge. The time of tracheal extubation and the intensive unit stay were reduces. 
Conclusions: More studies of high level of evidence are needed and the implementation of enhanced recovery program in cardiac surgery increase the perioperative quality care and allow better perioperative evolution of the patients.

Author(s): María Oslaida Agüero Martínez

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