The technological proposal based on enhanced recovery after cardiac surgery for changing traditional care in Latin America: REPLICCAR III Study Protocol

Sep 28, 2026

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Enhanced recovery protocols after cardiac surgery remain a key strategy to address prolonged postoperative hospitalization, supported by digital health applications that can reinforce protocol adherence. The REPLICCAR III study protocol, registered as NCT06786819, evaluates whether an optimization application integrated into an optimized, recovery-based pathway reduces postoperative length of stay in patients undergoing coronary artery bypass graft surgery (CABG) in São Paulo, Brazil, within a patient-centered care context.

LanguageEnglish

CategoryHealthcare

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Pages16

Reading Time40 min

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Abstract

Introduction

OPEN ACCESS Citation: Borgomoni GB, Reis PH, Pinheiro G, Ribas FF, da Silva GS, Campagnucci VP, et al. (2025) The technological proposal based on enhanced recovery after cardiac surgery for changing traditional care in Latin America: REPLICCAR III Study Protocol. PLoS One 20(12): e0338301. [https://doi.org/10.1371/](https://doi.org/10.1371/)[ ](https://doi.org/10.1371/)[journal.pone.0338301](journal.pone.0338301) Editor: Elma Izze Da Silva Magalhães, Federal University of Santa Maria: Universidade Federal de Santa Maria, BRAZIL Received: July 13, 2025 Accepted: November 18, 2025 Published: December 31, 2025 Copyright: © 2025 Borgomoni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: No datasets were generated or analysed during the current study. Funding: The study received funding support from the Fundação de Amparo à Pesquisa STUDY PROTOCOL The technological proposal based on enhanced recovery after cardiac surgery for changing traditional care in Latin America: REPLICCAR III Study Protocol Gabrielle Barbosa Borgomoni1*, Pedro Horigoshi Reis1, Guilherme Pinheiro1, Fernando Faglioni Ribas2☯, Gilmara Silveira da Silva2☯, Valquíria Pelisser Campagnucci3☯, Mário Issa4☯, Pedro Silvio Farsky4☯, Melina Moroz Barg4☯, Marcos Gradim Tiveron5☯, Luiz Fernando dos Reis Falcão6‡, Roger Daglius Dias7‡, Luiz Augusto Ferreira Lisboa1‡, Fabio Biscegli Jatene1‡, Omar Asdrúbal Vilca Mejia1* 1 Departamento de CardioPneumologia, Disciplina de Cirurgia Cardiovascular, Unidade Cirúrgicade Qualidade e Segurança, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Brazil, 2 Departamento de Cirurgia Cardiovascular, Beneficiencia Portuguesa de Sao Paulo, Brazil, 3 Departamento de Cirurgia Cardiovascular, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Sao Paulo, Brazil, 4 Divisão de Cirurgia, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil, 5 Departamento de Cirurgia Torácica e Cardiovascular, Irmandade da Santa Casa de Misericórdia de Marília, Marilia, São Paulo, Brazil, 6 Departamento Anestesiologia, Dor e Medicina Intensiva, Disciplina de Anestesiologia e Dor, Escola Paulista de Medicina EPM – UNIFESP, Sao Paulo, Brazil, 7 Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, United States of America ☯ These authors contributed equally to this work. ‡ These authors also contributed equally to this work. * [omar.mejia@incor.usp.br](omar.mejia@incor.usp.br) (OAVM), [gabrielle.barbosa@hc.fm.usp.br](gabrielle.barbosa@hc.fm.usp.br) (GBB) Abstract The length of hospital stay following cardiac surgery remains a significant challenge. Enhanced recovery protocols, alongside the use of health applications, offer promising potential for safely and effectively reducing postoperative length of stay. The Registro Paulista de Cirurgia Cardiovascular III (REPLICCAR III) study, registered at [Clinicaltrials.gov](Clinicaltrials.gov) (NCT06786819), aimed to investigate the impact of an optimization application integrated within an optimized recovery-based protocol on postoperative hospitalization duration in patients undergoing Coronary Artery Bypass Graft Surgery (CABG) in the state of São Paulo. Introduction Advances in cardiac surgery, driven by large databases, risk scoring systems, and technical innovations, have been significant [ 1–3] . However, the length of postoperative hospital stay remains a persistent challenge, especially within the Brazilian Unified Health System, where the average stay for coronary artery bypass graft (CABG) PLOS One | [https://doi.org/10.1371/journal.pone.0338301](https://doi.org/10.1371/journal.pone.0338301) December 31, 2025 1 / 16 do Estado de São Paulo – FAPESP ([https://](h

FAQs

What problem does the REPLICCAR III protocol target in cardiac surgery patients?

It targets the challenge of reducing postoperative length of hospital stay following cardiac surgery, which remains significant despite current advances.

What is the goal of integrating an optimization application in REPLICCAR III?

To assess whether a process-customized optimization application, integrated within an enhanced recovery-based protocol, can safely and effectively shorten postoperative hospitalization duration in CABG patients.

What study setting and patient group are covered by the protocol?

The protocol focuses on patients undergoing coronary artery bypass graft surgery (CABG) in the state of São Paulo, Brazil, as part of the Registro Paulista de Cirurgia Cardiovascular III (REPLICCAR III).

Sep 28, 2026

Uploaded by dhado