involving family physicians in preoperative preparation for eras colorectal surgery
TRANSCRIPT
June 2015 # 3
What is ERAS?
AKA Fast-track or ERP
Developed by Kehlet in
Denmark in colonic
surgery
Gradually has gained
world-wide acceptance
Originally described in
Open Surgery but same
advantages seem to
apply for Laparoscopy
June 2015 # 14
Anemia
Review NSQIP database 227,000 pts: 69,000 (30%) had
preop anemia
Postop mortality higher (OR 1.42)
Postop morbidity higher (OR 1.36)
H. Tønnesen et al. Br. J. Anaesth. 2009;102:297-306
© The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved. For Permissions, please e-mail: [email protected]
Smoking effect on pulmonary complications and rates of wound
infection
June 2015 # 18
Smoking
The 2nd issue is what time interval is appropriate for smoking cessation. In terms of the acute physiology that occurs when smokers first quit, what was theorized were the following time intervals:
- First 48 to 72 hours: quitters may have increased secretions and more reactive airways
- 2 to 4 weeks: decreased secretions and decreased airway reactivity
- 4 to 6 weeks: immune and metabolic function normalize
- 12 weeks for complete improvement of the airway lining mucociliary function and small airway function