Medicinal, Psychological, and Health Research Journal (MPHRJ)

Enhanced Recovery After Thoracotomy in the Intensive Care Unit: Current Evidence, Clinical Strategies, and Future Perspectives

Document Type : Review

Authors

Hosein Shiri 1
Nima Ashrafi 2

1 Assistant Professor of Surgery, Department of Cardiovascular Surgery, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 ICU fellowship candidate , Department of anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

https://doi.org/10.22034/mphrj.2026.586242.1095
Abstract
Enhanced Recovery After Surgery (ERAS) has emerged as an important perioperative framework for improving outcomes after thoracotomy, particularly in patients requiring intensive postoperative care. This review examines current evidence and practical strategies for applying ERAS principles in the intensive care unit after thoracic surgery. Key components include preoperative optimization through patient education, pulmonary assessment, smoking cessation, nutritional support, and anesthetic planning; intraoperative measures such as appropriate surgical technique selection, goal-directed fluid therapy, targeted anesthesia, multimodal analgesia, and tissue-sparing practice; and postoperative ICU management focused on hemodynamic monitoring, ventilatory support, pain control, chest tube care, mobilization, respiratory physiotherapy, and early nutritional intervention. Collectively, these measures aim to reduce pulmonary complications, shorten ICU and hospital stay, improve functional recovery, and enhance quality of life. The review also highlights important barriers to implementation, including protocol variability, limited resources, and the complexity of critically ill thoracic patients. Overall, ERAS provides a structured and multidisciplinary approach that aligns perioperative care with modern goals of safety, efficiency, and patient-centered recovery after thoracotomy.

Graphical Abstract

Enhanced Recovery After Thoracotomy in the Intensive Care Unit: Current Evidence, Clinical Strategies, and Future Perspectives

Keywords

thoracotomy
enhanced recovery after surgery
intensive care unit
perioperative care
Subjects
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Medicinal, Psychological, and Health Research Journal (MPHRJ)
Volume 2, Issue 5
September and October 2026
Pages 372-382

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