Clinical benefits after the implementation of a multimodal perioperative protocol in elderly patients.

Context: Multimodal protocol of perioperative care may enhance recovery after surgery. Based on evidence these new routines of perioperative care changed conventional prescriptions in surgery.

Objective: To evaluate the results of a multimodal protocol (ACERTO protocol) in elderly patients.

[Difference between intravenous crystalloid fluids prescribed and infused in patients during early postoperative period].

Objective: The aim of this study was to audit the real amount of crystalloid intravenous fluids infused in patients underwent major abdominal operations in a University hospital.

Methods: The whole intravenous crystalloid fluid load (CHT) infused from the 1st to the 4th postoperative day in 31 patients underwent major abdominal operations was registered. This amount was compared to the volume daily prescribed (CHP) by the physician.

Multimodal approach in colorrectal surgery without mechanical bowel cleansing.

Objective: To evaluate the outcomes after the implementation of a multimodal protocol (ACERTO protocol) with patients undergoing colorectal operations.

Methods: Fifty-three patients (37 M and 16 F; 57 [18-82] years old) submitted to various colorectal operations were prospectively studied in two different periods of time: from January 2004 through July 2005 (n=25, conventional group) and from August 2005 through June 2008 (n=28; ACERTO group). The patients received either the traditional perioperative management (including mechanical bowel cleansing) or a multidisciplinary protocol of perioperative care (without mechanical bowel cleansing) established by the ACERTO protocol.