Perioperative Care and Enhanced Recovery After Cardiothoracic Surgery: Evidence-Based Protocols and Outcomes

The perioperative period in cardiothoracic surgery represents a critical window during which coordinated, evidence-based care can substantially reduce morbidity, shorten recovery, and improve patient-reported outcomes. This chapter reviews the development and implementation of enhanced recovery after surgery (ERAS) protocols tailored to cardiac and thoracic surgical populations, including preoperative optimization, multimodal analgesia, early extubation, goal-directed fluid therapy, and structured rehabilitation pathways. Evidence from prospective studies and institutional ERAS program reports is synthesized to identify best practices, address persistent gaps in implementation, and outline directions for future quality improvement and outcomes research in cardiothoracic perioperative medicine.