Digital ERAS platform to shorten hospital stay after coronary artery bypass grafting

Estudo Randomizado de Cluster Escalonado Para Avaliar o Impacto de Uma Plataforma tecnológica Baseada no ERAS (Enhanced Recovery After Surgery) no Tempo de permanência após Cirurgia de revascularização miocárdica: Projeto Tempos Certos - REPLICCAR III

This project tests a digital platform based on ERAS to see if it shortens hospital stays for adults having primary isolated CABG.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 480 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Sao Paulo General Hospital (other)
• Locations: 2 sites (São Paulo, São Paulo and 1 other locations)
• Trial ID: NCT06786819 on ClinicalTrials.gov

What this trial studies

This interventional project implements an Enhanced Recovery After Surgery (ERAS) pathway supported by a digital platform for adults undergoing primary isolated coronary artery bypass grafting. Participants who own and can use a smartphone will receive perioperative care guidance, monitoring, and communications through the platform while clinical outcomes are tracked. The main outcome is hospital length of stay, with safety and adherence monitored using standard preoperative and postoperative criteria. The trial is conducted at InCor (Hospital das Clínicas, FMUSP) within a framework informed by regional cardiovascular registry data.

Who should consider this trial

Good fit: Adults 18 or older scheduled for primary isolated CABG who own and can use a smartphone with internet access and meet basic medical/laboratory criteria (for example, Hb ≥12 g/dL, creatinine clearance ≥30 mL/min, A1c ≤8%).

Not a fit: Patients needing additional cardiac procedures, with preoperative atrial fibrillation or anticoagulation, very poor kidney function, severe anemia, STS score >4%, illicit drug use, or those unable to use a smartphone are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, the platform could help patients leave the hospital sooner, recover faster, and potentially experience fewer complications and lower costs.

How similar studies have performed: Similar ERAS pathways and some digital perioperative programs have been associated with shorter stays and faster recovery in observational studies and limited trials, but combining ERAS with a dedicated digital platform for CABG is still relatively novel.

Eligibility criteria

Inclusion Criteria:

* Adults over 18 years old
* Indication for primary isolated CABG (elective or urgent status)
* Own a personal cell phone
* Have internet access
* Knowledgeable in using the device
* Full understanding and agreement regarding the informed consent form (ICF)

Exclusion Criteria:

* Indication for associated surgery
* Glycosylated hemoglobin level greater than 8%
* Creatinine clearance less than 30 mL/min
* Pre-operative atrial fibrillation or use of pre-operative anticoagulation
* Hemoglobin less than 12 g/dL
* Users of illicit drugs
* STS score greater than 4%
* Physical or mental disabilities that prevent adherence to the protocol
* Refusal by the patient or family member

Where this trial is running

São Paulo, São Paulo and 1 other locations

• InCor - Instituto do Coração do Hospital das Clínicas da FMUSP — São Paulo, São Paulo, Brazil (RECRUITING)
• InCor - Instituto do Coração do Hospital das Clínicas da FMUSP — São Paulo, São Paulo, Brazil (NOT_YET_RECRUITING)

Study contacts

• Principal investigator: Omar A V Mejia, MD, PhD — InCor - Instituto do Coração do Hospital das Clínicas da FMUSP
• Study coordinator: Omar A V Mejia, MD, PhD

Conditions: ERAS, Cardiac Surgery, Cardiac Surgery-CABG, Digital Health, CABG, ERASCS