Vias de recuperación mejorada perioperatoria. Adaptación a la cirugía pediátrica

Andrés Broggi, María Laura Illescas, Héctor Pacheco, Carlos Juambeltz

Resumen


Dos grandes cambios han mejorado los resultados anestesicoquirurgicos en los últimas décadas. La cirugía mínimamente invasiva (CMI) y la atención multidisciplinaria perioperatoria incorporando la medicina basada en la evidencia.Tradicionalmente, los cirujanos, anestesiólogos y enfermeras han prestado atención a las experiencias individuales. Las vías de recuperación mejorada “ERAS” por sus siglas en ingles (Enhanced Recovery After Surgery) representan un cambio paradigmático de la atención tradicional, buscando integrar múltiples elementos individuales de la atención perioperatoria, así como el compromiso de los pacientes y cuidadores para comprender mejor el proceso de recuperación. Al aprovechar los logros alcanzados por las técnicas de CMI con las vías ERAS, el objetivo fue mejorar aún más la recuperación, disminuir las complicaciones y disminuir la variabilidad en la práctica, lo que a su vez se reflejaría en una internación más corta y con menos costos asistenciales. El desarrollo de la vía de recuperación mejorada no consiste en crear nuevas hipótesis para una mejor atención, sino más bien en la organización de la mejor evidencia científica disponible, que ayude a estandarizar la atención a través de una práctica, institución o sociedad profesional.

En la siguiente revisión bibliográfica, buscamos el enfoque desde el punto de vista de la cirugía pediátrica, la cual presenta cada vez mas interés en esta modalidad de atención.


Palabras clave


cirugía pediátrica; cirugía mínimamente invasiva; vías de recuperación mejorada; ERAS

Texto completo:

PDF

Referencias


http://erassociety.org

Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitated programme. Br J Surg. 1999;86(2):227-30.

Kehlet H. Fast-Track colonic surgery: status and perspectives. Recent Results Cancer Res. 2005;165:8-13.

Lungqvist O. ERAS Enhanced Recovery After Surgery: Moving evidence-based perioperative care to practice. J Parenter Enteral Nutr. 2014;38(5):559-66

Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24(3):466-477.

Shinnick JK, Short HL, Heiss KF, Santore MT, Blakely ML, Raval MV. Enhancing recovery in pediatric surgery: a review of the literature. J Surg Res. 2016;202(1):165–76.

Bessey PQ. Metabolic response to critical illness. En: Wilmore DW, Cheung LY, eds. Scientific American Surgery. New York: Scientific American Inc, 1995; 1–31.

Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248(2):189–98.

Nicholson A, Lowe MC, Parker J, Lewis SR, Alderson P, Smith AF. Systematic review and meta-analysis of enhanced recovery

programmes in surgical patients. Br J Surg. 2014;101(3):172–88.

Zhuang CL, Ye XZ, Zhang XD, Chen BC, Yu Z. Enhanced recovery after surgery programs versus traditional care for colorectal surgery: a meta-analysis of randomized controlled trials. Dis Colon Rectum. 2013;56(5):667–78.

Raval MV, Dillon PW, Bruny JL, Ko CY, Hall BL, Moss RL, et al. American College of Surgeons National Surgical Quality Improvement Program pediatric: A phase 1 report. J Am Coll Surg 2011;212(1):1–11

Feng C, Sidhwa F, Cameron DB, Glass C, Rangel SJ. Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program. J Pediatr Surg 2016;51(6):970-4.

Mattei P. Fast-Track Protocols. En: Mattei P. editor. Fundamentals of Pediatric Surgery. Springer; 2009. Cap 6. p. 37-40.

Sandora TJ, Fung M, Melvin P, Graham DA, Rangel SJ. National variability and appropriateness of surgical antibiotic prophylaxis in US children’s hospitals. JAMA Pediatr 2016;170(6):570–6.

Slusher J, Bates CA, Johnson C, Williams C, Dasgupta R, Von Allmen D. Standardization and improvement of care for pediatric patients with perforated appendicitis. J Pediatr Surg 2014;49(6):1020–5.

Adibe OO, Iqbal CW, Sharp SW, Juang D, Snyder CL, Holcomb GW, et al. Protocol versus ad libitum feeds after laparoscopic pyloromyotomy: A prospective randomized trial. J Pediatr Surg 2014;49(1):129–32.

West MA, Horwood JF, Staves S, Jones C, Goulden MR, Minford J, et al. Potential benefits of fast-track concepts in paediatric colorectal surgery. J Pediatr Surg 2013;48(9):1924–30.

Short HL, Taylor N, Piper K, Raval MV. Appropriateness of a pediatric-specific enhanced recovery protocol using a modified Delphi process and multidisciplinary expert panel. J Pediatr Surg 2018;53(4):592-98.

Short HL, Heiss KF, Burch K, Travers C, Edney J, Venable C, et al, Implementation of an enhanced recovery protocol in pediatric colorectal surgery. J Pediatr Surg. 2018;53(4):688-92.

Corbett S. Respuesta sistémica a la lesión y apoyo metabólico. En: Brunicardi C. editor. Schwartz Principios de cirugía. 10a edición. Mcgraw Hill, 2015. Cap 2.

Raines A, Garwe T, Wicks R, Palmer M, Wood F, Adeseye A, et al: Pediatric appendicitis: The prevalence of systemic inflammatory response syndrome upon presentation and its association with clinical outcomes. J Pediatr Surg. 2013;48(12):2442-45.

Chawla BK,Teitelbaum DH. Profound systemic inflammatory response syndrome following non-emergent intestinal surgery in children. J Pediatr Surg. 2013;48(9):1936-40.

Kehlet H. Surgical stress and postoperative outcome—from here to where? Reg Anesth Pain Med. 2006;31(1):47–52.

Ayyadhah Alanazi A. Reducing anxiety in preoperative patients: a systematic review. Br J Nurs. 2014;23(7):387–93

Vrecenak JD, Mattei P. Fast-track management is safe and effective after bowel resection in children with Crohn's disease. J Pediatr Surg. 2014;49(1):99-102.

Krane E, Rhodes E, Claure R, Rowe E, Wolfsdorf J. Essentials of Endocrinology. En: Coté C, Lerman J, Anderson B. A Practice of Anesthesia for Infants and Children. Elsevier, 2018. Cap 27. p. 629-54.

Leys C, Austin M, Pietsch JB, Lovvorn HN. Elective intestinal operations in infants and children without mechanical bowel preparation: a pilot study. J Pediatr Surg 2005;40(6):978-81.

Breckler FD, Rescorla FJ, Billmire DF. Wound infection after colostomy closure for imperforate anus in children: utility of preoperative oral antibiotics. J Pediatr Surg. 2010;45(7):1509-13.

Serrurier K, Liu J, Breckler F, Khozeimeh N, Billmire D, Gingalewski C, et al. A multicenter evaluation of the role of mechanical bowel preparation in pediatric colostomy takedown. J Pediatr Surg. 2012;47(1):190-3.

Aldrink JH, McManaway C, Wang W. Mechanical bowel preparation for children undergoing elective colorectal surgery. J Pediatr Gastroenterol Nutr. 2015;60(4):503-7.

Shah M, Ellis CT, Phillips M, Marzinsky A, Adamson W, Weiner T, et al. Preoperative bowel preparation prior to elective bowel resection or ostomy closure in the pediatric patient population has no impact on outcomes: a prospective randomized study. Am Surg. 2016;82: 801-6.

Ares G, Helenowski I, Hunter C, Madonna M, Reynolds M, Lautz T. Effect of preadmission bowel preparation on outcomes of elective colorectal procedures in young children. J Pediatr Surg. 2018;53(4):704-7.

Soop M, Nygren J, Myrenfors P, Thorell A, Ljunggvist O. Preoperative oral carbohydrate treatment attenuates immediate postoperative insulin resistance. Am J Physiol Endocrinol Metab. 2001;280(4):576-83.

Maltby JR. Fasting from midnight the history behind the dogma. Best Pract Res Clin Anaesthesiol. 2006;20(3):363-78.

DeAguilar-Nascimento JE, Perrone F, de Assuncao Prado LI. Preoperative fasting of 8 hours or 2 hours: what does evidence reveal? Rev Col Bras Cir. 2009;36(4):350-2.

Brady M, Kinn S, O´Rourke K, Randhawa N, Stuart P. Ayuno prequirúrgico para la prevención de complicaciones perioperatorias en niños. La Biblioteca Cochrane Plus. 2008;4.

Kuster F, Alberti M, González L, Priori L, Lamas M. Pautas de Ayuno para Procedimientos Bajo Anestesia del Hospital de Clínicas. Montevideo: Facultad de Medicina, Cátedra de Anestesiología, 2016

Brunet-Wood K, Simons M, Evasiu A, Mazurak V, Dicken B, Ridley D, et al. Surgical fasting guidelines in children: Are we putting them into practice? J Pediatr Surg 2016;51(8):1298-302.

Song IK, Kim HJ, Lee JH, Kim EH, Kim JT, Kim HS. Ultrasound assessment of gastric volume in children after drinking carbohydrate-containing fluids. Br J Anaesth. 2016;116(4):513-7.

Andersson H, Zarén B, Frykholm P. Low incidence of pulmonary aspiration in children allowed intake of clear fluids until called to the operation suite. Pediatr Anesth. 2015;25(8):770–7 .

Sanders RD, Davidson A. Anesthetic induced neurotoxicity of the neonate: time for clinical guidelines?. Pediatric Anesth. 2009;19(12):1141-6.

Tander B, Baris S, Karakaya D, Ariturk E, Rizalar R, Bernay F. Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia. Pediatr Anesth. 2005;15(7):574-9.

Bourdaud N, Devys JM, Bientz J, Lejus C, Hebrard A, Tirel O, et al. Development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients: the VPOP score. Pediatr Anesth. 2014;24(9):945-52.

Gupta A, Stierer T, Zuckerman R, Sakima N, Parker SD, Fleisher LA. Comparison of recovery profile after ambulatory anesthesia with propofol, isoflurane, sevoflurane and desflurane: a systematic review. Anesth Analg. 2004;98(3):632-41.

Lönnqvist PA. Inappropriate perioperative fluid management in children: Time for a solution? Paediatr Anaesth 2007;17(3):203-5.

Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatrics. 1957;19(5):823-32.

Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and metaanalysis. J Gastrointest Surg. 2009;13(3):569-75.

Sangkhathat S, Patrapinyokul S, Tadyathikom K. Early Enteral Feeding After Closure of Colostomy in Pediatric Patients. J PediatrSurg. 2003;38(10):1516-9.

Ashok V, Bala I, Bharti N, Jain D, Samujh R. Effects of intraoperative liberal fluid therapy on postoperative nausea and vomiting in children - A randomized controlled trial. Paediatr Anesth. 2017;27(8):810-5.

Drysdale SB, Coulson T, Cronin N, Manjal ZR, Piyasena C, North A, et al.The impact of the National Patient Safety Agency intravenous fluid alert on iatrogenic hyponatraemia in children. Eur J Pediatr. 2010;169(7):813-7.

Way C, Dhamrait R, Wade A, Walker I. Perioperative fluid therapy in children: a survey of current prescribing practice.Br J Anaesth. 2006;97(3):371-9.

Yung M1, Keeley S. Randomised controlled trial of intravenous maintenance fluids. J Paediatr Child Health. 2009;45(1-2):9-14.

Kehlet H. Manipulation of the metabolic response in clinical practice. World J Surg. 2000;24(6):690–5.

Association of Paediatric Anaesthetists of Great Britain and Ireland. Good Practice in Postoperative and Procedural Pain Management. Pediatr Anesth. 2012;22(Suppl 1):1-79.

Kulshrestha A, Bajwa SJS. Management of acute postoperative pain in pediatric patients. Anaesth Pain & Intensive Care. 2014;18(1):101-5.

Buvanendran A, Kroin JS. Useful adjuvants for postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007;21(1):31-49.

Bucher BT, Guth RM, Elward AM, Hamilton NA, Dillon PA, Warner BW, et al. Risk factors and outcomes of surgical site infection in children. J Am Coll Surg. 2011;212(6):1033-8.

Feng C, Sidhwa F, Cameron DB, Glass C, Rangel SJ. Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program. J Pediatr Surg. 2016;51(6):970-4.

Rangel SJ, Islam S, St Peter SD, Goldin AB, Abdullah F, et al. Prevention of infectious complications after elective colorectal surgery in children: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee review. J Pediatr Surg. 2015;50(1):192-200.

Renko M, Paalanne N, Tapiainen T, Hinkkainen M, Pokka T, Kinnula S, et al. Triclosan-containing sutures versus ordinary sutures for reducing surgical site infections in children: a double-blind, randomised controlled trial. Lancet Infect Dis. 2017;17(1):50-7.

Ruiz-Canela Cáceres J, García Vera C. Las suturas absorbibles que contienen triclosán disminuyen las tasas de infección de la herida quirúrgica en los niños. Evid Pediatr. 2017;13(2):25.

Allegranzi B, Bischoff P, de Jonge S, Kubilay N, Zayed B, Gomes S, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 2016;16(12):e276-87.

Allegranzi B, Bischoff P, de Jonge S, Kubilay N, Zayed B, Gomes S, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 2016;168(12):e288-303.

Ekingen G, Ceran C, Guvenc BH, Tuzlaci A, Kahraman H. Early enteral feeding in newborn surgical patients. Nutrition. 2005;21(2):142-6.

Amanollahi O, Azizi B. The comparative study of the outcomes of early and late oral feeding in intestinal anastomosis surgeries in children. Afr J Paediatr Surg 2013;10(2):74-7.

Mamatha B, Alladi A. Early Oral Feeding in Pediatric Intestinal Anastomosis. Indian J Surg 2015;77(Suppl. 2):670–2.

Sangkhathat S, Patrapinyoku S, Tadyathikom K. Early Enteral Feeding After Closure of Colostomy in Pediatric Patients. J Pediatr Surg, 2003;38(10):1516-9.

Sholadoye TT, Suleiman AF, Mshelbwala PM, Ameh EA. Early oral feeding following intestinal anastomoses in children is safe. Afr J Paediatr Surg. 2012;9(2):113-6.

Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: Systematic review and meta-analysis of controlled trials. BMJ 2001;323(7316):773-6.

Hospital Infantil de México Federico Gómez. Early Feeding vs 5-day Fasting After Distal Elective Bowel Anastomoses in Children. A Randomized Controlled Trial. Hospital Infantil de Mexico Federico Gómez, 2010. Available from: www.bioportfolio.com/resources/trial/70013.

Aljahdali A, Mohajerani N, Skarsgard ED. Effect of timing of enteral feeding on outcome in gastroschisis. J Pediatr Surg. 2013;48(5):971–6.

Jensen A, Renaud E, Drucker NA, Staszak J, Senay A, Umesh V, et al.Why Wait?: Early Enteral Feeding After Pediatric Gastrostomy Tube Placement. J Pediatr Surg. 2018;53(4):656-60.

Adibe OO, Iqbal CW, Sharp SW, Juang D, Snyder CL, Holcomb GW, et al. Protocol versus ad libitum feeds after laparoscopic pyloromyotomy: A prospective randomized trial. J Pediatr Surg. 2014;49(1):129-32.

Yadav S, Choudhury S, Grover JK, Gupta A, Chadha R, Sigalet DL..Early feeding in pediatric patients following stoma closure in a resource limited environment. J Pediatr Surg. 2013;48(5):977-82.

Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointestinal Surg. 2013;17(5):962–72.

Sandler A, Evans D, Ein, SH. To tube or not to tube: do infants and children need post-laparotomy gastric decompression? Pediatr Surg Int. 1998;13(5-6):411-3.

Davila-Perez R, Bracho-Blanchet E, Tovilla-Mercado JM, Hernandez-Plata JA, Reyes-Lopez A, Nieto-Zermeño J. Unnecessary Gastric Decompression in Distal Elective Bowel Anastomoses in Children: A Randomized Study. World J Surg 2010;34(5):947-53.

Khan N, Choudhury SR,Yadav PS, Prakash R, Patel JN. Role of nasogastric tube in children undergoing elective distal bowel surgery. Pediatr Surg Int. 2017;33(2):229-34.

Reismann M, Dingemann J, Wolters M, Laupichler B, Suempelmann R, Ure BM. Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children. Langenbecks Arch Surg, 2009;394(3):529-33.




DOI: http://dx.doi.org/10.25184/anfamed2018v5n2a9

Enlaces refback

  • No hay ningún enlace refback.




           Licencia Creative Commons Licencia Creative Commons Atribución 4.0 Internacional