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Examination of the enhanced recovery guidelines in thoracic surgery

Teeter, Emily G.a; Kolarczyk, Lavinia M.a; Popescu, Wanda M.b

Current Opinion in Anesthesiology: February 2019 - Volume 32 - Issue 1 - p 10–16
doi: 10.1097/ACO.0000000000000681
THORACIC ANESTHESIA: Edited by Albert C. Perrino Jr

Purpose of review Enhanced Recovery After Thoracic Surgery (ERATS) has gained momentum over the past few years, although the evidence base and expert recommendations lag behind other specialties. This review will present and examine key points from the first guidelines for enhanced recovery after lung surgery, released in 2018, jointly sponsored by the European Society of Thoracic Surgeons and the Enhanced Recovery After Surgery Society.

Recent findings The recently released guidelines present core components of enhanced recovery as they pertain to lung resection surgery. Although evidence is still sparse in some areas, the guidelines summarize the available literature and incorporate levels of recommendation based upon the strength of available data as well as expert consensus. As of yet, the relative contribution of individual ERATS components to improvement in outcomes is unclear, but overall compliance does seem to be linked to positive results. Since the creation of the guidelines, additional literature related to ERATS has been released, and it will be incorporated and discussed into our review.

Summary The creation of guidelines for enhanced recovery after lung resection will provide the thoracic anesthesiologist a framework upon which to build a comprehensive perioperative anesthetic plan.

aDepartment of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

bDepartment of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence to Emily G. Teeter, MD, FASE, Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, CB #7010, Chapel Hill, NC 27599-7010, USA. Tel: 1 (919) 966 5136; E-mail:

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