ImportanceNeonates requiring surgery are often cared for in neonatal intensive care units (NICUs). Despite a breadth of surgical pathology, neonates share many perioperative priorities that allow for the development of unit-wide evidence-based Enhanced Recovery After Surgery (ERAS) recommendations.ObservationsThe guideline development committee included pediatric surgeons, anesthesiologists, neonatal nurses, and neonatologists in addition to ERAS content and methodology experts. The patient population was defined as neonates (first 28 days of life) undergoing a major noncardiac surgical intervention while admitted to a NICU. After the first round of a modified Delphi technique, 42 topics for potential inclusion were developed. There was consensus to develop a search strategy and working group for 21 topic areas. A total of 5763 abstracts were screened, of which 98 full-text articles, ranging from low to high quality, were included. A total of 16 recommendations in 11 topic areas were developed with a separate working group commissioned for analgesia-related recommendations. Topics included team communication, preoperative fasting, temperature regulation, antibiotic prophylaxis, surgical site skin preparation, perioperative ventilation, fluid management, perioperative glucose control, transfusion thresholds, enteral feeds, and parental care encouragement. Although clinically relevant, there were insufficient data to develop recommendations concerning the use of nasogastric tubes, Foley catheters, and central lines.Conclusions and RelevanceDespite varied pathology, neonatal perioperative care within NICUs allows for unit-based ERAS recommendations independent of the planned surgical procedure. The 16 recommendations within this ERAS guideline are intended to be implemented within NICUs to benefit all surgical neonates.

中文翻译：

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加速康复外科 (ERAS) 协会对新生儿围手术期护理的建议


重要性需要手术的新生儿通常在新生儿重症监护病房 (NICU) 中接受护理。尽管外科病理学范围很广，但新生儿有许多共同的围手术期优先事项，以便制定全单位范围内基于证据的加速康复外科 (ERAS) 建议。观察指南制定委员会还包括儿科外科医生、麻醉师、新生儿护士和新生儿科医生ERAS 内容和方法专家。患者群体被定义为入住 NICU 期间接受重大非心脏手术干预的新生儿（出生后 28 天）。经过第一轮改进的 Delphi 技术后，开发了 42 个可能包含的主题。会议一致同意为 21 个主题领域制定检索策略和工作组。共筛选了5763篇摘要，其中包含98篇全文文章，质量从低到高不等。委托一个单独的工作组负责镇痛相关建议，共制定了 11 个主题领域的 16 项建议。主题包括团队沟通、术前禁食、温度调节、抗生素预防、手术部位皮肤准备、围手术期通气、液体管理、围手术期血糖控制、输血阈值、肠内喂养和家长护理鼓励。尽管具有临床相关性，但没有足够的数据来制定有关使用鼻胃管、Foley 导管和中心导管的建议。结论和相关性尽管病理情况各异，但 NICU 内的新生儿围手术期护理允许基于单位的 ERAS 建议，独立于计划的手术程序。 本 ERAS 指南中的 16 条建议旨在在 NICU 内实施，以使所有手术新生儿受益。