{"id":2813,"date":"2022-10-20T22:22:45","date_gmt":"2022-10-20T22:22:45","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=2813"},"modified":"2023-09-27T13:36:40","modified_gmt":"2023-09-27T13:36:40","slug":"eras-cardiac-surgery","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/eras-cardiac-surgery\/","title":{"rendered":"ERAS for Cardiac Surgery: Top 5 Facts with Dr. Judson Williams"},"content":{"rendered":"<p>Enhanced Recovery After Surgery (ERAS) is a revolutionary approach to improving patient outcomes that is now being adopted by leading cardiac centers that specialize in heart valve repair and replacement procedures.<\/p>\n<p>To learn more, we interviewed <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Judson-Williams-Raleigh-North%20Carolina.php\">Dr. Judson Williams<\/a>, a leading heart surgeon at WakeMed in Raleigh, North Carolina. It&#8217;s important to note that Dr. Williams was responsible for developing the first ERAS cardiac surgery program in the United States.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/mVL1UDstR7c?rel=0\" width=\"600\" height=\"338\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About ERAS for Cardiac Surgery<\/h2>\n<p>Here are several important learnings from our discussion with Dr. Williams:<\/p>\n<ul>\n<li>ERAS stands for enhanced recovery after surgery. While the ideas and processes in ERAS have been applied to many other surgical specialties, the application of ERAS to cardiac surgery is relatively new. &#8220;It&#8217;s been applied to other surgical specialties for decades but really only applied in a standardized fashion to cardiac surgery within the last few years,&#8221; states Dr. Judson. &#8220;It&#8217;s an interdisciplinary best practice, best evidence process for helping patients recover from a new heart valve or whatever heart surgery they need.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Judson-Williams-Raleigh-North%20Carolina.php\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full\" src=\"https:\/\/www.heart-valve-surgery.com\/profileImages\/451_129_175.jpg\" alt=\"Dr. Judson Williams Heart Surgeon\" width=\"129\" height=\"175\" \/><\/a><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Judson-Williams-Raleigh-North%20Carolina.php\">Dr. Judson Williams (Heart Surgeon)<\/a><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>One of the key components of ERAS for cardiac surgery is reducing opioid use for pain management following heart valve surgery. &#8220;Up to as many as 20% of patients prescribed opioids after an elective surgery will develop some type of opioid use disorder. This is one of the most frequent complications that we seek as surgeons to avoid,&#8221; states Dr. Williams. &#8220;In our program, we&#8217;ve reduced opioid use overall by 40%. Over 50% of our patients now are leaving the hospital with no need for an opioid prescription.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2817 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/opioid-reduction-eras-cardiac-surgery-wakemed.jpg\" alt=\"ERAS Cardiac Surgery - Opioid Reduction\" width=\"650\" height=\"367\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Carbohydrate loading is part of ERAS for cardiac surgery given its counter-intuitive benefits for patients. &#8220;Carbohydrate loading is a very interesting topic to surgeons, to anesthesiologists, and to patients alike,&#8221; states Dr. Williams. &#8220;It really is the idea that by giving the patient a carbohydrate beverage two to four hours prior to their operation, we can stimulate the gut, we can stimulate the pancreas, improve gut motility, improve glucose control and many of the outcomes associated with those.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2818 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/Eras-cardiac-surgery-carbohydrate-loading.jpg\" alt=\"ERAS for Cardiac Surgery - Carbohydrate Loading\" width=\"650\" height=\"368\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Best practices and process standardization is the foundation of ERAS. Dr. Williams states, &#8220;Enhanced Recovery is an aggregation of marginal gains that result in a big gain for the patient at the end. By standardizing best practice preoperatively, inter-operatively, and postoperatively for the patient, we are achieving those small gains at each step along the way.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2819 aligncenter\" src=\"https:\/\/www.heart-valve-surgery.com\/learning\/..\/Images\/eras-cardiac-surgery-best-practices.jpg\" alt=\"Eras Cardiac Surgery - Best Practices\" width=\"650\" height=\"366\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>ERAS protocols are designed to mitigate the risk of infections before, during and after surgery. &#8220;An infection prevention bundle should be a component of any surgical procedure, big or small,&#8221; states Dr. Williams. &#8220;This is especially critical for heart surgery and certainly for heart valve surgery patients. It&#8217;s the idea ERAS provides that platform for applying best practice and best evidence at every step of infection prevention.&#8221;<\/li>\n<li>Goal-directed therapy is deployed to keep the patient&#8217;s recovery on track. Dr. Williams states, &#8220;It&#8217;s the idea that we use the latest monitoring tools in an algorithmic way to know how much fluid a patient needs after heart surgery. Many heart valve patients will remember being very swollen after their operations. Having too much or too little can influence things like length of stay in the hospital, acute kidney injury, and other complications. We now have great minimally invasive technologies that can provide real-time data from the patient to guide an individualized approach, goal-directed, to fluid administration for patients after their heart valve surgery.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Many Thanks Dr. Williams &amp; WakeMed!<\/h2>\n<p>On behalf of our patient community, many thanks to <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Judson-Williams-Raleigh-North%20Carolina.php\">Dr. Judson Williams<\/a> for taking the time to share his clinical research and experience with us.\u00a0 In addition, we would like to thank the entire WakeMed\u00a0 team for taking such great care of heart valve patients.<\/p>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of Dr. Williams&#8217; interview below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[15],"class_list":["post-2813","page","type-page","status-publish","hentry","category-recovery"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2813","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=2813"}],"version-history":[{"count":8,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2813\/revisions"}],"predecessor-version":[{"id":3120,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/2813\/revisions\/3120"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=2813"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=2813"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}