Research AppraisalSystematic Review

What Is Included in Pediatric Enhanced Recovery After Surgery Protocols and How to Encourage Adoption: A Systematic Review of the Literature

Journal of the American College of SurgeonsDawson-Gore, Catherine C, Vincent, Sage A, Myers, Emily K et al.1 July 2026DOI

Clinical Snapshot

65CEBM

Evidence: ModerateSystematic Review

PICO Framework

P — Population	Pediatric patients undergoing various surgical procedures
I — Intervention	Enhanced Recovery After Surgery (ERAS) protocols
C — Comparator	Standard perioperative care or comparison between different ERAS elements
O — Outcomes	ERAS protocol elements, implementation strategies, and adoption barriers

Bottom Line

This systematic review provides the first comprehensive analysis of Enhanced Recovery After Surgery (ERAS) protocol elements used in pediatric surgery, identifying significant variation and gaps in current practice. While ERAS protocols have demonstrated benefits in adult surgery, their pediatric application remains inconsistent across institutions and procedures. The authors' identification of protocol variations and proposed methodology for standardization addresses a critical need in pediatric perioperative care. However, the descriptive nature of this review limits direct clinical application. Australian pediatric surgeons should consider this work as foundational for developing standardized pediatric ERAS protocols, particularly given the potential for improved outcomes and reduced healthcare costs. The review's findings support the need for collaborative development of evidence-based pediatric ERAS guidelines, which could be incorporated into Australian clinical practice standards. Further research evaluating clinical effectiveness of standardized pediatric ERAS protocols is warranted.

Evidence: Moderate

Key Findings

Effect Size: Not applicable - descriptive systematic review
Primary Outcome: Identification of ERAS protocol elements used in pediatric surgery
Nnt Or Sensitivity: Not applicable - protocol analysis rather than clinical effectiveness
Confidence Interval: Not reported

Clinical Application

High feasibility as ERAS protocols are adaptable to existing surgical workflows Highly relevant to Australian pediatric surgery centers; aligns with ANZCA and RACS quality improvement initiatives; may inform development of Australian pediatric ERAS guidelines Pediatric surgical patients across various procedures in tertiary care settings

Abstract

The present systematic review is the first to describe and analyze the breadth of enhanced recovery after surgery (ERAS) elements across various pediatric surgery procedures. The aim of the article is to provide a compendium of ERAS elements that are used in pediatric protocols to identify both gaps and variation. In response to these findings, we then propose a methodology for addressing the gaps and variation we found and furthering the use of ERAS in pediatric surgery.

References

1.Dawson-Gore, C. C., Vincent, S. A., Myers, E. K., Downton, K. D., Barone-Camp, A. L., Brockel, M. A., Rove, K. O., & Acker, S. N. (2024). What Is Included in Pediatric Enhanced Recovery After Surgery Protocols and How to Encourage Adoption: A Systematic Review of the Literature. Journal of the American College of Surgeons. https://doi.org/10.1097/XCS.0000000000001923

Share:X LinkedIn

Related Research

other

85CEBM

Scientific data

Appendix300: Surgical video and patient metadata of 330 laparoscopic appendectomy cases from five institutions

14 June 2026

observational

75CEBM

Journal of the American College of Surgeons

Improving Trauma Triage Accuracy with Large Language Models: A Comparison to Human Expert Decisions