American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery.
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The primary driver of length of stay after bowel surgery, particularly colorectal surgery, is the time to return of gastrointestinal (GI) function. Traditionally, delayed GI recovery was thought to be a routine and unavoidable consequence of surgery, but this has been shown to be false in the modern era owing to the proliferation of enhanced recovery protocols. However, impaired GI function is still common after colorectal surgery, and the current literature is ambiguous with regard to the definition of postoperative GI dysfunction (POGD), or what is typically referred to as ileus. This persistent ambiguity has impeded the ability to ascertain the true incidence of the condition and study it properly within a research setting. Furthermore, a rational and standardized approach to prevention and treatment of POGD is needed. The second Perioperative Quality Initiative brought together a group of international experts to review the published literature and provide consensus recommendations on this important topic with the goal to (1) develop a rational definition for POGD that can serve as a framework for clinical and research efforts; (2) critically review the evidence behind current prevention strategies and provide consensus recommendations; and (3) develop rational treatment strategies that take into account the wide spectrum of impaired GI function in the postoperative period.
Published Version (Please cite this version)10.1213/ane.0000000000002742
Publication InfoThacker, Julie; Miller, Timothy; Wischmeyer, Paul; Hedrick, Traci L; McEvoy, Matthew D; Mythen, Michael Monty G; ... Fiore, Julio F (2018). American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery. Anesthesia and analgesia, 126(6). pp. 1896-1907. 10.1213/ane.0000000000002742. Retrieved from https://hdl.handle.net/10161/17253.
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Associate Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine; with particular interests in fluid management, and perioperative optimization of the high-risk non-cardiac surgery patient.
Associate Professor of Surgery
Professor of Anesthesiology
Paul Wischmeyer M.D. is a Perioperative physician who specializes in enhancing preparation and recovery from surgery and critical care. Specifically, at Duke he practices on the Critical Care and Nutrition clinical teams. He serves as the Director of Perioperative Research for the Duke Clinical Research Institute and Associate Vice Chair for Clinical Research in the Dept. of Anesthesiology. He also serves as the Director of the Nutrition Support Team at Duke. Dr. Wischmeyer e
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