Protocols of early recovery in heart surgery: utopia or reality?

Abstract

Introduction: The concept of rapid or early recovery protocols was inserted into clinical practice by Henrik Kehlet in 1997, with the aim of improving the quality of perioperative care and decreasing morbidity and mortality.
Objective: To determine that the implementation of protocols in heart surgery is no longer a utopia.
Methods: The bibliographic search was made up of all the published articles that evaluated the usefulness of the rapid or early recovery protocols.
Development: Early recovery protocols have been developed for decades and comprise a set of actions that cover the entire perioperative period. A multidisciplinary team is needed to achieve complete adherence. Its implementation began in colorectal surgery and it was gradually expanded and adapted to almost all surgical specialties. In heart surgery for non-specific reasons, including the use of extracorporeal circulation, the implementation has been delayed but the existing scientific evidence, although not enough, shows that adherence to these protocols influences positively the recovery of patients; so, the need to standardize them has arisen.
Conclusions: The implementation of these protocols in heart surgery is now a reality. In April 2017, the company responsible for this process was created, whose motto is to optimize perioperative care through a collaborative analysis, consensus of experts and the dissemination of best practices.