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Survey on the Application of European Guidelines for
Enhanced Recovery After Lung Surgery (ERAS)

Introduction

This survey aims to assess the current implementation of the Enhanced Recovery After Surgery (ERAS) Society and the European Society of Thoracic Surgeons (ESTS) Guidelines for enhanced recovery following lung surgery.

Your responses will help identify practice patterns and guide future clinical trials in this area.

The survey is anonymous, and you may skip any of 57 questions at your discretion. Estimated completion time is <10 minutes.

Thank you for your participation.
1.For authorship purposes only, please write your full name, email address and affiliation, as you would like it to appear in the manuscript (these details will be dealt with confidentiality).
Those who opt not to write their name will not be listed among the collaborators.
Part 1: Respondent Information
2.Age:
3.Gender:
4.Professional status:
5.Specialty:
6.Practice setting:
7.Years of experience in your field:
8.Primary clinical activity:
9.Annual volume of pulmonary resections (segmentectomy, wedge, lobectomy) in your institution:
10.Familiarity with the ERAS Guidelines:
(please indicate your level of familiarity with the guidelines)
Part 2: Application of the ERAS-ESTS Guidelines
Patient Selection and Information
11.Does your institution hold an official ERAS accreditation or certification?
12.Do you have a formal ERAS pathway for thoracic surgery patients?
13.During the surgical consultation, how do you provide preoperative information to patients?
(check all that apply)
14.During pre-anesthetic consultation, how do you provide preoperative information to patients?
(check all that apply)
15.Do you formally assess patient eligibility for the ERAS pathway?
16.What is the usual practice for postoperative patient admission following lung surgery?
Preoperative Management and Rehabilitation
17.Do you routinely perform preoperative nutritional assessment (i.e. weight loss, albumin levels, or validated tools)?
18.Do you provide preoperative nutritional support when needed?
19.Smoking cessation intervention:
20.Alcohol cessation intervention:
21.Preoperative pulmonary rehabilitation:
22.Preoperative anemia management:
Anesthesia and Analgesia for Pulmonary Resections
23.Preoperative fasting protocol:
24.Do you use preoperative carbohydrate loading?
25.Premedication practices:
26.Primary hypnotic agent used perioperatively:
27.Which regional anesthesia techniques are routinely used in your institution for VATS procedures?
(check all that apply)
28.Which regional anesthesia techniques are routinely used in your institution for thoracotomy procedures?
(check all that apply)
29.Do you apply lung-protective ventilation strategies during one-lung ventilation (e.g. tidal volume of 4–6 mL/kg and individualized PEEP optimization)?
30.Postoperative nausea and vomiting prophylaxis:
(check all that apply)
31.Strategies for prevention of postoperative atrial fibrillation:
(check all that apply)
32.In case of atrial fibrillation prevention strategies, which strategy is preferred? (check all that apply)
33.What is your institution’s antibiotic prophylaxis strategy for lung surgery? (check all that apply)
34.Methods to prevent intraoperative hypothermia:
(check all that apply)
35.Perioperative fluid management:
Surgical Strategy
36.Preferred surgical approach for lobectomy:
(check all that apply)
37.What percentage of lobectomies do you perform by VATS and/or RATS?
38.Which specific surgical strategies do you use to minimize operative trauma in VATS lung resections?
(check all that apply)
39.Which chest tube drainage system do you use:
(check all that apply)
40.What is your standard chest tube management strategy after lung surgery?
(check all that apply)
Postoperative Rehabilitation
41.When do patients typically begin oral intake after lung surgery in your department?
42.When does the early mobilization protocol begin in your department:
43.What does the venous thromboembolism prophylaxis include in your department:
44.Do you use a standardized multimodal analgesic protocol in the postoperative period?
45.If yes, which of the following components are included in your regimen?
46.What is the bladder tube management in your department:
47.What is the routine use of postoperative ventilatory support in your department:
48.What type of postoperative chest physiotherapy is conducted in your department:
Part 3: Detailed Practice Patterns in Enhanced Recovery for Thoracic Surgery
49.Which elements of enhanced recovery protocols do you find most challenging to implement?
(select up to 3 answer choices)
50.What are the main barriers to implementation of enhanced recovery protocols in your institution?
(check all that apply)
51.Have you observed any of the following outcomes after implementing enhanced recovery protocol?
(check all that apply)
52.How do you measure compliance with your enhanced recovery protocol?
(check all that apply)
53.Since the publication of the European guidelines, how has your practice changed regarding ERAS protocol for thoracic surgery?
54.Which areas of ERAS following lung resection do you believe require further research?
(check all that apply)
55.Are there specific patient populations for whom you do not apply the ERAS approach?
(check all that apply)
56.What percentage of your eligible thoracic surgery patients are managed with the ERAS approach?
57.Additional comments on your experience with ERAS in thoracic surgery:
Many thanks for sharing your insights with us.
Results from this questionnaire will be published and will be further discussed.

The Authors
Current Progress,
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