Enhanced Recovery After Surgery: What Is the Role of Nutrition?
Multidisciplinary perioperative protocols, commonly known as Enhanced Recovery After Surgery (ERAS®) protocols, were pioneered in the 1990’s. Initially, they were developed specifically for elective colorectal surgery. However, they are now being adapted for many types of surgeries. These protocols include multiple interventions intended to shorten the time to return of bowel function and discharge from the hospital after surgery. Preoperative nutrition assessment, shortening pre- and post-operative oral diet fasting practices, and adding a preoperative carbohydrate beverage are key components of the protocols. Other components include patient education, optimizing intraoperative intravenous fluid administration, early postoperative mobilization, and limiting the use of opioids. In this presentation, a nurse anesthetist who specializes in Enhanced Recovery Programs will provide a broad view of the history of and rationale for Enhanced Recovery, as well as real-world experiences in implementation of Enhanced Recovery protocols. An RDN will discuss the nutrition components of Enhanced Recovery, the evidence for these components and the role of the RDN in Enhanced Recovery protocol implementation.
Planned with the Dietitians in Nutrition Support Dietetic Practice Group.
- Outline the rationale and components of Enhanced Recovery Programs
- Describe the fasting and feeding components of an Enhanced Recovery Program
- Examine the evidence for the nutrition components of Enhanced Recovery Programs
- 1.2.2 Identifies the knowledge and skills required to provide service.
- 8.3.6 Keeps abreast of current nutrition and dietetics knowledge and trends.
- 8.1.1 Interprets and applies evidence-based comparative standards for determining nutritional needs.
Stephanie Dobak, MS, RD, LDN, CNSC
Clinical Dietitian III
Jefferson Weinberg ALS Center
Kate Willcutts, DCN, RDN, CNSC
Clinical Nutrition Manager
University of Virginia Health System
Kara Douglas, MSN, APN, CRNA
Director of Enhanced Recovery After Surgery
American Anesthesiology of Maryland, Greater Baltimore Medical Center