Prophylactic effect of Amiodarone and in combination with vitamin C in reducing atrial fibrillation after coronary artery bypass

Impact of Limited Enhanced Recovery Pathway for Cardiac Surgery: A Single-Institution Experience

OBJECTIVES

Enhanced recovery pathway (ERP) refers to extensive multidisciplinary, evidence-based pathways used to facilitate recovery after surgery. The authors assessed the impact that limited ERP protocols had on outcomes in patients undergoing cardiac surgery at their institution.

DESIGN

A retrospective cohort study.

SETTING

This study was a single-institution study conducted at a university hospital.

PARTICIPANTS

Patients undergoing open adult cardiac surgery.

INTERVENTIONS

Enhanced recovery pathways limited to preoperative, intraoperative, and postoperative management of pain, atrial fibrillation prevention, and nutrition optimization were implemented.

MEASUREMENTS AND MAIN RESULTS

A total of 1,058 patients were included in this study. There were 374 patients in each pre- and post-ERP cohort after propensity matching, with no significant baseline differences between the 2 cohorts. Compared to the matched patients in the pre-ERP group, patients in the post-ERP group had decreased total ventilation hours (6.8 v 7.8, p = 0.006), less use of postoperative opioid analgesics as determined by total morphine milligram equivalent (32.5 v 47.5, p < 0.001), and a decreased rate of postoperative atrial fibrillation (23.3% v 30.5%, p = 0.032). Post-ERP patients also experienced less subjective pain and postoperative nausea and drowsiness as compared to their matched pre-ERP cohorts.

CONCLUSIONS

Limited ERP implementation resulted in significantly improved perioperative outcomes. Patients additionally experienced less postoperative pain despite decreased opioid use. Implementation of ERP, even in a limited format, is a promising approach to improving outcomes in patients undergoing cardiac surgery.

Research output of Iran over the past two years: Contributions from the European Journal of Translational Myology

Over the last two decades, all branches of science and technology have rapidly progressed, including the medical area. In Middle Eastern countries, including Iran, the increased growth of technology and science production has led to this rapid medical progress. Recent evidence has revealed that the increase in the number of scientific papers generated in Iran after the Iraqi imposed war against Iran has been eight times that in six main countries in the Middle East, including Egypt, Turkey, Jordan, Saudi Arabia, Iraq, and Syria. Although Iran’s output in sciences has been still small in comparison to developed countries, it has significantly grown in the last decade, which is hoped to continue to increase and improve. The current paper shows a portion of the science production in Iran over the past two years based on papers published in the European Journal of Translational Myology in 2020 and 2021. Although the Issue 32(1), 2022 in a special section contains several typescripts from Iran, they were not included in our analysis since they have not been yet indexed in the Scopus database. However, our report would encourage researchers of diverse nationalities to take part in research works and author joint papers. Further, this paper can be used to rate the universities and research centers regarding their science output, as well as being beneficial to university students, lecturers, and governments.