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Review
. 2022 Dec;37(12):5326-5335.
doi: 10.1111/jocs.17226. Epub 2022 Nov 30.

Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis

Wenjuan Feng  1 , Jing Zhou  2   3 , Yu Lei  1 , Wenmin Chen  1 , Yongpin Miao  1 , Xintong Fu  1 , Jinghong Pi  1 , Min Zhang  1 , Zhuhui Na  1 , Wenrong Lou  4
Affiliations
Review

Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis

Wenjuan Feng et al. J Card Surg. 2022 Dec.

Abstract

Objective: To systematically evaluate the effect of enhanced recovery after surgery (ERAS) on perioperative nursing of patients undergoing cardiac surgery.

Methods: A systematic literature search was performed in PubMed, Embase, Web of science, Cochrane, CNKI, Wanfang, and VIP using predefined search strings from inception of database to May 2021. Randomized control trials (RCTs) with sample size >40 on cardiac surgery with either ERAS nursing or routine nursing reporting extubation (trachea) time, length of stay, out of bed activity time, and nursing satisfaction were included in the analysis. Stata SE 12.0 software was used for statistical analysis.

Results: A total of 27 RCTs were included. All the included studies were Chinese due to lack of studies in English. The results of meta-analysis showed that the extubation time standardized mean difference ([SMD] = -3.11; 95% confidence interval [CI]: -3.77, -2.45; p < .001), out of bed activity time (SMD = -2.89; 95% CI: -3.34, -2.44; p < .001), and hospitalization time (SMD = -2.08; 95% CI: -2.37, -1.79; p < .001) of cardiac surgery patients with ERAS nursing was significantly shorter than those with routine nursing. The patient's satisfaction after surgery with ERAS was higher than that of routine nursing relative risk ([RR] = 1.24; 95% CI: 1.18, 1.30; p < .001).

Conclusion: ERAS nursing can accelerate perioperative rehabilitation of patients undergoing cardiac surgery and highly accepted by patients.

Keywords: cardiac surgery; enhanced recovery after surgery; meta-analysis; perioperative period; randomized controlled trial.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systemic reviews and Meta‐Analyses flow chart
Figure 2
Figure 2
Forest plot. (A) Extubation time. (B) Subgroup analysis of extubation time. CI, confidence interval; SMD, standardized mean differences.
Figure 3
Figure 3
Forest plot. (A) Length of hospital stay. (B) Subgroup analysis of length of hospital stay. CI, confidence interval; SMD, standardized mean differences.
Figure 4
Figure 4
Forest plot of out of bed activity time. CI, confidence interval; SMD, standardized mean differences.
Figure 5
Figure 5
Forest plot of out of bed activity time. CI, confidence interval; ERAS, enhanced recovery after surgery.
Figure 6
Figure 6
Funnel plots. (A) Extubation time.  (B) Length of hospital stay. (C) Out of bed activity time. SMD, standardized mean differences.
Figure 7
Figure 7
Sensitivity analysis. (A) Extubation time. (B) Length of hospital stay. (c) Out of bed activity time. CI, confidence interval.
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