Fast-track key points for patients undergoing thoracic surgery

Section: Revisiones

How to quote

Subirana-Ferrés C, Déniz-Armangol C, Ruiz-Barrio P, Díaz-Martos I, García-Hornos E, Romero-Navarrete N. Puntos clave en el fast-track a los pacientes intervenidos de cirugía torácica. Metas Enferm oct 2020; 23(8):7-18. Doi: https://doi.org/10.35667/MetasEnf.2020.23.1003081646

Authors

Cristina Subirana-Ferrés1, Carlos Javier Déniz-Armangol2, Isabel Díaz-Martos3, Elena García-Hornos4,Nuria Romero-Navarrete5, Piedad Ruiz-Barrio6

Position

1Máster. Grado en Enfermería. Enfermera Clínica. Unidad de Cirugía Torácica. Área Médica y Cirugía Torácica. Hospital Universitario de Bellvitge. Barcelona2Especialista en Cirugía Torácica. Residente de cirugía. Unidad de Cirugía Torácica. Área Médica y Cirugía Torácica. Hospital Universitario de Bellvitge. Barcelona3Máster. Grado en Enfermería. Adjunta a Dirección de Enfermería. Hospital Universitario de Bellvitge. Barcelona4Licenciada en Enfermería. Enfermera asistencial. Hospital Universitario de Bellvitge. Barcelona5Máster. Licenciada en Enfermería. Supervisora. Unidad de Neumología. Área Médica y Cirugía Torácica. Hospital Universitario de Bellvitge. Barcelona6Máster. Licenciada en Enfermería. Supervisora. Unidad de Cirugía Torácica. Área Médica y Cirugía Torácica. Hospital Universitario de Bellvitge. Barcelona

Contact address

Cristina Subirana-Ferrés. Servicio de enfermedades respiratorias, infecciosas y medicina interna. Hospital Universitario de Bellvitge. Feixa Llarga, s

Contact email: csubirana@bellvitgehospital.cat

Abstract

Objective: to understand the fast-track key points in patients undergoing thoracic surgery.
Method: a narrative review. The following databases were used: CINHAL, Pubmed and Cochrane Library Plus. Search terms: fast-track, thoracic surgery and ERAS. Inclusion criteria: studies dealing with fast-track in thoracic surgery (neither tracheal resection nor mediastinum surgery), >18-year-old, published in the past 10 years, in English or Spanish.
Results: seventeen (17) articles were selected. Results were classified into three parts: 1) Preoperative stage, assigning high importance to smoking cessation, information provided to patients about the surgery and its evolution process, the concept of “prehabilitation”, screening for malnutrition, pulmonary conditions and anaemia, among others; 2) Intraoperative process, highly focused on minimizing the most aggressive surgical techniques, using anesthetic techniques more beneficial for patients, maintaining the patient in normothermia, conducting protective ventilation, and reducing the saline therapy load; 3) Postoperative period, where the time of absolute diet for the patient is reduced, mobilization is encouraged, pain is controlled to some extent in order to prevent complications, discharge criteria are understood, and patient empowerment is encouraged for their correct recovery and evolution.
Conclusion: it is important to understand the role of the nurse in the implementation of a fast-track protocol, because it helps to reduce surgical stress, there is a reduction in cost and hospital stay, patient empowerment is encouraged through early postsurgical recovery, and the patient is treated from a more holistic nursing perspective.

Keywords:

Fast-track; thoracic surgery; ERAS

Versión en Español

Título:

Puntos clave en el fast-track a los pacientes intervenidos de cirugía torácica