Episode 88: ERAS for Cardiac Surgery with Mike Grant

Enhanced Recovery After Surgery (ERAS) protocols represent a multidisciplinary, evidence-based approach to perioperative care designed to reduce surgical stress and accelerate patient recovery. Dr. Michael Grant, an assistant professor of anesthesiology and critical care, details the implementation of a cardiac-specific ERAS program at Johns Hopkins. Key interventions include preoperative carbohydrate loading, multimodal opioid-sparing analgesia using gabapentin and acetaminophen, and goal-directed perfusion strategies. Intraoperative management emphasizes lung-protective ventilation and early extubation, while postoperative care prioritizes early mobilization, aggressive diuresis, and standardized antiarrhythmic therapy. By shifting from a surgeon-led model to a collaborative, transdisciplinary framework, these protocols significantly reduce hospital-associated infections, opioid reliance, and overall length of stay. This systematic approach transforms the surgical experience into a structured, patient-centered journey, ultimately improving clinical outcomes and resource utilization across the entire cardiac surgical service line.