Enhanced Recovery After Cardiac Surgery: Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Membership Survey

Alexander J Gregory; Emily Teeter; Carlos Galhardo Jr; Stephanie O Ibekwe; Hilary P Grocott; Wanda M Popescu; Michael C Grant; SCA ERACS Survey Writing Group

doi:10.1053/j.jvca.2026.02.017

Enhanced Recovery After Cardiac Surgery: Society of Cardiovascular Anesthesiologists (SCA) and American Society of Anesthesiologists (ASA) Membership Survey

J Cardiothorac Vasc Anesth. 2026 Jun;40(6):1722-1739. doi: 10.1053/j.jvca.2026.02.017. Epub 2026 Feb 14.

Authors

Alexander J Gregory¹, Emily Teeter², Carlos Galhardo Jr³, Stephanie O Ibekwe⁴, Hilary P Grocott⁵, Wanda M Popescu⁶, Michael C Grant⁷; SCA ERACS Survey Writing Group

Collaborators

SCA ERACS Survey Writing Group:
Jafer Ali⁸, Bradlee J Bachar⁹, Rafael Cabrales¹⁰, Albert T C Cheung¹¹, Joshua B Cohen⁴, Srdjan Jelacic¹², Lavinia Kolarczyk¹³, Megan J Lanigan¹⁴, Annemarie Thompson¹⁵, Tiffany M Williams¹⁶

Affiliations

¹ Department of Anesthesiology, Perioperative and Pain Medicine, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada. Electronic address: alex.gregory@albertahealthservices.ca.
² Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
³ Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
⁴ Department of Anesthesiology, Baylor College of Medicine, Houston, TX.
⁵ University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Anesthesiology, Yale School of Medicine, New Haven, CT.
⁷ Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
⁸ Scope Anesthesia of North Carolina, NC (Atrium Health).
⁹ Kaweah Health.
¹⁰ Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Florida, FL.
¹¹ Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA.
¹² Department of Anesthesiology, University of Washington, Seattle, WA.
¹³ Department of Anesthesiology, University of North Carolina, Chapel Hill, NC.
¹⁴ University of Minnesota, Minneapolis, MN.
¹⁵ Department of Anesthesiology, Medicine, and Population Health, Divisions of Cardiothoracic Anesthesia and Critical Care, Duke University School of Medicine, Durham, NC.
¹⁶ Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, CA.

PMID: 41846213
DOI: 10.1053/j.jvca.2026.02.017

Abstract

Objectives: To assess the implementation rates within 2 society memberships of enhanced recovery elements for cardiac surgery.

Design: Survey on individual and institutional practice patterns of perioperative recommendations from the Enhanced Recovery After Surgery (ERAS) Cardiac Society.

Setting: International, multi-institutional; academic, public, and private.

Participants: Members of the Society of Cardiovascular Anesthesiologists (SCA) and the American Society of Anesthesiologists (ASA).

Intervention: Anonymous electronic survey with 45 questions on 30 enhanced recovery elements.

Primary outcome: Quantifying degrees of implementation of the ERAS recommendations into high (>70%), intermediate (25-69%), or low (<25%).

Measurements and main results: Data were summarized with descriptive statistics and margins of error. A total of 399 members responded (SCA, n = 138; ASA, n = 261). Reported rates of implementation vary between elements. Elements reported as highly implemented include limiting nil per os status, postoperative nausea and vomiting prevention, early extubation, and multimodal analgesia. Those reported as intermediate implementations include goal-directed therapy, regional analgesia, and prevention of acute kidney injury. Low implemented elements include the use of digital technology, prehabilitation, and standardized nutritional support.

Conclusions: While a low response rate and other biases limit generalizable conclusions, the subset of SCA and ASA members who responded report implementing enhanced recovery elements heterogeneously. Complex, costly, transdisciplinary elements seem to be applied to a lesser degree. These results identify potential areas of perioperative care that could be candidates for further research, education, and advocacy.

Keywords: ERAS; enhanced recovery; perioperative care; quality of recovery.

MeSH terms

Anesthesiologists* / standards
Anesthesiologists* / trends
Cardiac Surgical Procedures* / methods
Cardiac Surgical Procedures* / standards
Cardiac Surgical Procedures* / trends
Enhanced Recovery After Surgery* / standards
Humans
Perioperative Care* / methods
Perioperative Care* / standards
Societies, Medical* / standards
Surveys and Questionnaires
United States / epidemiology