Consensus-based eligibility criteria and component definitions for neonatal and infant enhanced recovery pathway: a multidisciplinary delphi study

Abstract

Abstract Objective The 2020 Enhanced Recovery After Surgery (ERAS®) guidelines for neonatal intestinal surgery have not been widely implemented due to unclear eligibility criteria and poorly defined components. We sought to establish consensus-based eligibility criteria and definitions for a revised enhanced recovery pathway (ERP). Study design We conducted two modified Delphi processes to establish eligibility criteria and define the components by engaging stakeholders including surgeons, anesthesiologists, neonatologists, nurses, dietitians, quality improvement specialists, and parents/caregivers at six pediatric hospitals. Eligibility criteria were established through two survey rounds; components were defined through two survey rounds and one focus group. Results Forty-five stakeholders participated (82% response). Consensus supported inclusion of infants born ≥32 weeks’ gestation or ≥1.5 kg undergoing elective/semi-urgent gastrointestinal surgery and defined 19 components, with 10 initially accepted and 9 revised. Conclusions The consensus-based Delphi process established eligibility and defined the components to facilitate implementation and adoption of an ERP for neonates and infants undergoing gastrointestinal surgery.