. 2020 Aug;44(8):2482-2492.

doi: 10.1007/s00268-020-05530-1.

Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Mary E Brindle^{1

2}, Caraline McDiarmid^{3

4}, Kristin Short³, Kathleen Miller³, Ali MacRobie³, Jennifer Y K Lam³, Megan Brockel⁵, Mehul V Raval⁶, Alexandra Howlett⁷, Kyong-Soon Lee⁸, Martin Offringa⁸, Kenneth Wong⁹, David de Beer¹⁰, Tomas Wester¹¹, Erik D Skarsgard¹², Paul W Wales¹³, Annie Fecteau¹³, Beth Haliburton¹³, Susan M Goobie¹⁴, Gregg Nelson¹⁵

Affiliations

¹ Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada. MaryEBrindle@gmail.com.
² Department of Surgery and Community Health Sciences, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada. MaryEBrindle@gmail.com.
³ Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada.
⁴ Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
⁵ Department of Anesthesiology, Children's Hospital Colorado, 13123 E 16th Avenue, Aurora, CO, 80045, USA.
⁶ Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA.
⁷ Section of Neonatology, Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada.
⁸ Division of Neonatology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
⁹ Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, William M. W. Mong Block, Hong Kong, China.
¹⁰ Department of Pediatric Anesthesia, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.
¹¹ Department of Pediatric Surgery, Karolinska University Hospital, Eugeniavagen 23, 171 76, Solna, Stockholm, Sweden.
¹² Department of Pediatric Surgery, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3N1, Canada.
¹³ Division of General and Thoracic Surgery, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
¹⁴ Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard University, 300 Longwood Avenue, Boston, MA, 02115, USA.
¹⁵ Department of Oncology, Cumming School of Medicine, University of Calgary, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada.

PMID: 32385680
PMCID: PMC7326795
DOI: 10.1007/s00268-020-05530-1

Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Mary E Brindle et al. World J Surg. 2020 Aug.

. 2020 Aug;44(8):2482-2492.

doi: 10.1007/s00268-020-05530-1.

Authors

Affiliations

¹ Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada. MaryEBrindle@gmail.com.
² Department of Surgery and Community Health Sciences, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada. MaryEBrindle@gmail.com.
³ Department of Surgery, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada.
⁴ Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
⁵ Department of Anesthesiology, Children's Hospital Colorado, 13123 E 16th Avenue, Aurora, CO, 80045, USA.
⁶ Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA.
⁷ Section of Neonatology, Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, AB, T3B 6A8, Canada.
⁸ Division of Neonatology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
⁹ Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, William M. W. Mong Block, Hong Kong, China.
¹⁰ Department of Pediatric Anesthesia, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.
¹¹ Department of Pediatric Surgery, Karolinska University Hospital, Eugeniavagen 23, 171 76, Solna, Stockholm, Sweden.
¹² Department of Pediatric Surgery, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3N1, Canada.
¹³ Division of General and Thoracic Surgery, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
¹⁴ Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard University, 300 Longwood Avenue, Boston, MA, 02115, USA.
¹⁵ Department of Oncology, Cumming School of Medicine, University of Calgary, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada.

PMID: 32385680
PMCID: PMC7326795
DOI: 10.1007/s00268-020-05530-1

Abstract

Background: Enhanced Recovery After Surgery (ERAS^®) Society guidelines integrate evidence-based practices into multimodal care pathways that have improved outcomes in multiple adult surgical specialties. There are currently no pediatric ERAS^® Society guidelines. We created an ERAS^® guideline designed to enhance quality of care in neonatal intestinal resection surgery.

Methods: A multidisciplinary guideline generation group defined the scope, population, and guideline topics. Systematic reviews were supplemented by targeted searching and expert identification to identify 3514 publications that were screened to develop and support recommendations. Final recommendations were determined through consensus and were assessed for evidence quality and recommendation strength. Parental input was attained throughout the process.

Results: Final recommendations ranged from communication strategies to antibiotic use. Topics with poor-quality and conflicting evidence were eliminated. Several recommendations were combined. The quality of supporting evidence was variable. Seventeen final recommendations are included in the proposed guideline.

Discussion: We have developed a comprehensive, evidence-based ERAS guideline for neonates undergoing intestinal resection surgery. This guideline, and its creation process, provides a foundation for future ERAS guideline development and can ultimately lead to improved perioperative care across a variety of pediatric surgical specialties.

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Conflict of interest statement

Gregg Nelson has a nonfinancial relationship with the ERAS^® Society as their secretary.

Figures

**Fig. 1**
Elements of the ERAS^® approach for neonatal intestinal resection surgery. Refer to Table 2 for greater detail on each recommendation

See this image and copyright information in PMC

Comment in

Invited Commentary: "Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations".
Rice HE. Rice HE. World J Surg. 2020 Aug;44(8):2493-2494. doi: 10.1007/s00268-020-05526-x. World J Surg. 2020. PMID: 32355986 No abstract available.

References

1. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292. - PubMed
1. Brindle M, Nelson G, Lobo DN, et al. Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines. BJS Open. 2020;4(1):157–163. - PMC - PubMed
1. Nelson G, Kiyang LN, Crumley ET, et al. Implementation of Enhanced Recovery After Surgery (ERAS) across a provincial healthcare system: the ERAS Alberta Colorectal Surgery Experience. World J Surg. 2016;40(5):1092–1103. doi: 10.1007/s00268-016-3472-7. - DOI - PubMed
1. Shinnick JK, Short HL, Heiss KF, et al. Enhancing recovery in pediatric surgery: a review of the literature. J Surg Res. 2016;202(1):165–176. - PubMed
1. Gillis C, Gill M, Marlett N, et al. Patients as partners in enhanced recovery after surgery: a qualitative patient-led study. BMJ Open. 2017;7(6):e017002. - PMC - PubMed

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Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Affiliations

Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Authors

Affiliations

Abstract

Conflict of interest statement

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Comment in

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Medical