The Enhanced Recovery After Surgery in Cardiac Surgery Revolution

In this issue of JAMA Surgery, the Enhanced Recovery After Surgery (ERAS) in Cardiac Surgery recommendations are published as a joint effort between the ERAS Cardiac Surgery (http://www.erascardiac.org)and the ERAS Society (http://www.erassociety. org). 1 This is another step in a transformation of care that is sweeping across the world with the adoption of the principles of ERAS within another important area of surgery, 2 cardiac surgery.The reasons for the success of ERAS lie in the outstanding results that can be achieved by using the principles of ERAS: multiprofessional and multidisciplinary teamwork, an application of evidence-based best practices of care (guidelines), continuous audits of outcomes and processes, and a readiness to make the next change.2 Applying ERAS principles results in a 30% to 40% reduction in the number of complications reported in several surgeries, shortening recovery time and ultimately freeing up hospital beds to save costs for payers. 2 New data are also suggesting survival benefits.3 While this guideline is a milestone for ERAS in cardiac surgery, it is just a beginning.Enhanced Recovery After Surgery guidelines need to be updated as new information emerges.Enhanced Recovery After Surgery is not another static surgical or anesthesia guideline.It is a new approach to care that will change surgery at its roots.The fundamental approach of ERAS will transform surgery.