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      Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

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          Abstract

          Background

          This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol.

          Methods

          A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations.

          Results

          The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries.

          Conclusion

          A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

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          Most cited references295

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          Driving pressure and survival in the acute respiratory distress syndrome.

          Mechanical-ventilation strategies that use lower end-inspiratory (plateau) airway pressures, lower tidal volumes (VT), and higher positive end-expiratory pressures (PEEPs) can improve survival in patients with the acute respiratory distress syndrome (ARDS), but the relative importance of each of these components is uncertain. Because respiratory-system compliance (CRS) is strongly related to the volume of aerated remaining functional lung during disease (termed functional lung size), we hypothesized that driving pressure (ΔP=VT/CRS), in which VT is intrinsically normalized to functional lung size (instead of predicted lung size in healthy persons), would be an index more strongly associated with survival than VT or PEEP in patients who are not actively breathing.
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            What is "quality of evidence" and why is it important to clinicians?

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              Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018

              This is the fourth updated Enhanced Recovery After Surgery (ERAS®) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol.
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                Author and article information

                Contributors
                erik.stenberg@regionorebrolan.se
                Journal
                World J Surg
                World J Surg
                World Journal of Surgery
                Springer International Publishing (Cham )
                0364-2313
                1432-2323
                4 January 2022
                4 January 2022
                2022
                : 46
                : 4
                : 729-751
                Affiliations
                [1 ]GRID grid.15895.30, ISNI 0000 0001 0738 8966, Department of Surgery, Faculty of Medicine and Health, , Örebro University, ; Örebro, Sweden
                [2 ]GRID grid.411249.b, ISNI 0000 0001 0514 7202, Discipline of Anesthesia, Pain and Critical Care Medicine, , Federal University of São Paulo, ; São Paulo, Brazil
                [3 ]GRID grid.443984.6, ISNI 0000 0000 8813 7132, Dietetic Department, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, ; Leeds, UK
                [4 ]GRID grid.413370.2, ISNI 0000 0004 0405 8883, Department of Surgery, Groene Hart Hospital, ; Gouda, Netherlands
                [5 ]Dutch Obesity Clinic, The Hague, Netherlands
                [6 ]GRID grid.416201.0, ISNI 0000 0004 0417 1173, Department of Upper GI and Bariatric/Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, ; Southmead Road, Bristol, UK
                [7 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Department of Surgery, , University of Turku, ; Turku, Finland
                [8 ]GRID grid.410552.7, ISNI 0000 0004 0628 215X, Division of Digestive Surgery and Urology, Turku University Hospital, ; Turku, Finland
                [9 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, ; Boston, MA USA
                [10 ]GRID grid.267313.2, ISNI 0000 0000 9482 7121, Department of Anesthesiology, Outcomes Research Institute, Cleveland Clinic, , University of Texas Southwestern, ; Dallas, USA
                [11 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, ; Stockholm, Sweden
                [12 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, ; Stockholm, Sweden
                [13 ]GRID grid.414628.d, ISNI 0000 0004 0618 1631, Department of Surgery, Ersta Hospital, ; Stockholm, Sweden
                Author information
                http://orcid.org/0000-0001-9189-0093
                Article
                6394
                10.1007/s00268-021-06394-9
                8885505
                34984504
                f351daf0-dedb-4b3a-8604-c51cdf5e14c6
                © The Author(s) 2021, corrected publication 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 October 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007436, Familjen Erling-Perssons Stiftelse;
                Award ID: 140604
                Funded by: FundRef http://dx.doi.org/10.13039/501100009228, Region Örebro län;
                Award ID: OLL-939106
                Funded by: FundRef http://dx.doi.org/10.13039/501100009336, Bengt Ihres Foundation;
                Funded by: Örebro University
                Categories
                Scientific Review
                Custom metadata
                © The Author(s) under exclusive licence to Société Internationale de Chirurgie 2022

                Surgery
                Surgery

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