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2026№6

Enhanced recovery after cardiac surgery: ERACS concept, the role of the therapist, and local intervention

DOI
https://dx.doi.org/10.18565/therapy.2026.6.144-152

O.G. Musaev, V.I. Vechorko, A.O. Shevchenko, K.B. Lebedeva, N.V. Viktorov

1) O.M. Filatov Moscow City Clinical Hospital No. 15, Moscow, Russian Federation; 2) N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
Abstract. Enhanced recovery after cardiac surgery (ERACS) program integrates preoperative correction of modifiable risk factors, standardized anesthetic and surgical management, multimodal analgesia, early reinstatement of nutrition and activity, complication prevention, and continuity of care.
The aim of the review was to summarize current data on ERACS, define the role of the physician, and present principles for its local implementation. A targeted, non-systematic search of relevant scientific sources was performed in PubMed, Cochrane Library, and Google Scholar for the period 2019–2026. The most consistent results presented in the reviewed literature are associated with a reduction in the duration of mechanical ventilation, intensive care unit stay, and hospitalization with the implementation of ERACS. However, the impact of ERACS on mortality and severe complications remains poorly understood. The article also discusses monitoring of protocol component implementation and maintaining a local registry.

Keywords

enhanced recovery after surgery
ERACS
cardiac surgery
perioperative management
preoperative optimization
multimodal analgesia
early mobilization
therapist
Full text (in Russian)

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About the Authors

Orkhan G. Musaev, MD, head of the Department of cardiac surgery, cardiovascular surgeon, O.M. Filatov Moscow City Clinical Hospital No. 15, Moscow, Russian Federation.
E-mail: bhhb@mail.ru
ORCID: https://orcid.org/0000-0001-9728-1563
Valery I. Vechorko, MD, Dr. Sci. (Medicine), chief physician at O.M. Filatov Moscow City Clinical Hospital No. 15; head and professor of the Department of ambulance and emergency medical care, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
E-mail: vvechorko@yandex.ru
ORCID: https://orcid.org/0000-0003-3568-5065
Alexey O. Shevchenko, MD, Dr. Sci. (Medicine), professor, corresponding member of RAS, acting head of the regional vascular center, O.M. Filatov Moscow City Clinical Hospital No. 15; professor, head of the Department of cardiology of the Institute of continuing professional development, N.I. Pirogov Russian National Research Medical University; chairman of the Expert Council of Academician V.I. Shumakov National Medical Research Center for Transplantology and Artificial Organs, Moscow, Russian Federation.
E-mail: alxxshevchenko@aol.com
ORCID: https://orcid.org/0000-0003-4719-9486
Karina B. Lebedeva, MD, cardiovascular surgeon at O.M. Filatov Moscow City Clinical Hospital No. 15; assistant at the Department of hospital surgery No. 1 named after V.S. Mayat of the Institute of surgery, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
E-mail: kardamowa.carina@yandex.ru
ORCID: https://orcid.org/0009-0009-6456-9021
Nikolay V. Viktorov, resident of the Department of hospital surgery No. 1 named after V.S. Mayat of the Institute of surgery, N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation.
E-mail: nv.viktorov@outlook.com
ORCID: https://orcid.org/0009-0002-3494-8644
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