Priority 15 from the Heart Surgery PSP

UNCERTAINTY: Does ERAS (Enhanced Recovery After Surgery) improve outcomes in heart surgery? (JLA PSP Priority 15)
Overall ranking 15
JLA question ID 0088/15
Explanatory note Enhanced recovery is a modern evidence-based approach that helps people recover more quickly after having major surgery. Whilst the principles of enhanced recovery can be applied to all cases of surgery, specially designed pathways for cardiac surgery help patients benefit from the principles more effectively. ~ Does Enhanced Recovery after Surgery (ERAS®) improve clinical outcomes of cardiac surgery?  Which is the best timing to awake the patient after the surgery? Does local anesthesia improve recovery after cardiac surgery?
Evidence

Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database of Systematic Reviews. 2014(8); Wong WT, Lai VKW, Chee YE, Lee A. Fast‐track cardiac care for adult cardiac surgical patients. Cochrane Database of Systematic Reviews. 2016(9). 
Health Research Classification System category Cardiovascular
Extra information provided by this PSP
Original uncertainty examples Does Enhanced Recovery after Surgery (ERAS®) improve clinical outcomes after cardiac surgery? ~ Which is the best timing to awake the patient after the surgery? ~ Does HFNO (High-flow nasal oxygen) in patients with increased risk have any effect pre-op? 
Submitted by 4 x patient, 3 x carer, 17 x healthcare professional,  3 x others 
PSP information
PSP unique ID 0088
PSP name Heart Surgery
Total number of uncertainties identified by this PSP. 45  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 11 July 2019