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. 2024 Oct 14;24(1):512.
doi: 10.1186/s12890-024-03286-1.

Impact of an enhanced recovery after surgery program integrating cardiopulmonary rehabilitation on post-operative prognosis of patients treated with CABG: protocol of the ERAS-CaRe randomized controlled trial

Qingyan Yang #  1 , Lu Wang #  2 , Xintong Zhang #  1 , Peng Lu #  3 , Dijia Pan #  1 , Shurui Li #  1 , Yuewei Ling #  4   5 , Xiaohui Zhi #  1 , Lingfeng Xia  1 , Ye Zhu  1 , Ying Chen  1 , Chaoyang Liu  3 , Wanjun Jin  3 , Jan D Reinhardt  6   7   8   9 , Xiaowei Wang  10 , Yu Zheng  11
Affiliations

Impact of an enhanced recovery after surgery program integrating cardiopulmonary rehabilitation on post-operative prognosis of patients treated with CABG: protocol of the ERAS-CaRe randomized controlled trial

Qingyan Yang et al. BMC Pulm Med. .

Abstract

Background: Coronary artery bypass grafting is associated with a high occurrence of postoperative cardiopulmonary complications. Preliminary evidence suggested that enhanced recovery after surgery can effectively reduce the occurrence of postoperative cardiopulmonary complications. However, enhanced recovery after surgery with systematic integration of cardiopulmonary rehabilitation (ERAS-CaRe) into for Coronary artery bypass grafting has not been evaluated so far. We thus design the ERAS-CaRe randomized-controlled trial to evaluate possible superiority of embedding cardiopulmonary rehabilitation in ERAS over ERAS alone as well as to investigate effects of differential timing of cardiopulmonary rehabilitation within enhanced recovery after surgery (pre-, post-, perio-operative) on post-operative cardiopulmonary complications following Coronary artery bypass grafting surgery.

Methods: ERAS-CaRe is a pragmatic, randomized-controlled, parallel four-arm, clinical trial. Three hundred sixty patients scheduled for Coronary artery bypass grafting in two Chinese hospitals will be grouped randomly into (i) Standard enhanced recovery after surgery or (ii) pre-operative ERAS-CaRe or (iii) post-operative ERAS-CaRe or (iv) perio-operative ERAS-CaRe. Primary outcome is the occurrence of cardiopulmonary complications at 10 days after Coronary artery bypass grafting. Secondary outcomes include the occurrence of other individual complications including cardiac, pulmonary, stroke, acute kidney injury, gastrointestinal event, ICU delirium rate, reintubation rate, early drainage tube removal rate, unplanned revascularization rate, all-cause mortality, ICU readmission rate, plasma concentration of myocardial infarction-related key biomarkers etc. DISCUSSION: The trial is designed to evaluate the hypothesis that a cardiopulmonary rehabilitation based enhanced recovery after surgery program reduces the occurrence of cardiopulmonary complications following Coronary artery bypass grafting and to determine optimal timing of cardiopulmonary rehabilitation within enhanced recovery after surgery. The project will contribute to increasing the currently limited knowledge base in the field as well as devising clinical recommendations.

Trial registration: The trial was registered at the Chinese Clinical Trials Registry on 25 August 2023 (ChiCTR2300075125; date recorded: 25/8/2023, https://www.chictr.org.cn/ ).

Keywords: Cardiopulmonary complications; Cardiopulmonary rehabilitation; Coronary artery bypass grafting; Enhanced recovery after surgery; Full disease cycle; Randomized controlled trial.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the ERAS-CaRe trial.  CABG: Coronary artery bypass graft; CAD: coronary artery disease; CR: cardiopulmonary rehabilitation; ERAS-CaRe: enhanced recovery after surgery program integrating cardiopulmonary rehabilitation program; ERAS: enhanced recovery after surgery; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association
Fig. 2
Fig. 2
Flow diagram of ERAS-CaRe program. CABG: Coronary artery bypass graft; CAD: coronary artery disease; CR: cardiopulmonary rehabilitation; ERAS-CaRe: enhanced recovery after surgery program integrating cardiopulmonary rehabilitation program; ERAS: enhanced recovery after surgery
See this image and copyright information in PMC

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