ABSTRACT
Abstract Background Cardiac surgery causes pathophysiological changes that favor the occurrence of pulmonary and functional complications. Objective To investigate the effects of inspiratory muscle training (IMT) with an electronic device on patients undergoing cardiac surgery. Methods A randomized controlled trial was conducted with 30 adult patients undergoing elective cardiac surgery. A control group (CG) received conventional physical therapy care, and an intervention group (IG) received IMT using the POWERbreathe K5® electronic device. Two daily sessions of physical therapy were performed at the intensive care unit and one daily session at the ward until the sixth postoperative day. The following variables were measured preoperatively and on the sixth postoperative day, in both groups: inspiratory muscle strength, dynamic inspiratory muscle strength, and peak inspiratory flow. Data distribution was evaluated by the Shapiro-Wilk test. Analysis of variance was used, and the results were considered statistically significant when p < 0.05. Results Maximal inspiratory pressure (71.7 ± 17.1 cmH2O vs 63.3 ± 21.3 cmH2O; p = 0.11], S-index (52.61 ± 18.61 vs 51.08 ± 20.71), and peak inspiratory flow [(2.94 ± 1.09 vs 2.79 ± 1.26)] were maintained in the IG but had a significant reduction in the CG. Conclusion IMT performed with an electronic device was effective at maintaining inspiratory muscle strength, dynamic inspiratory muscle strength, and peak inspiratory flow when compared to conventional physical therapy. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Breathing Exercises/methods , Physical Therapy Modalities/instrumentation , Thoracic Surgical Procedures/rehabilitation , Postoperative Complications , Respiratory Tract Diseases/complications , Total Lung Capacity , Thoracic Surgical Procedures/adverse effects , Muscle Strength , Maximal Respiratory PressuresABSTRACT
Introducción: Para disminuir la lista de espera para la cirugía cardiaca electiva, en 1999 el Instituto Nacional de Cardiología Ignacio Chávez inició un programa de vía rápida para casos de muy bajo riesgo quirúrgico. En 2004, este programa se extendió a pacientes con riesgo intermedio. Objetivos: Estudio prospectivo, descriptivo, para evaluar las características clínicas y demográficas de los pacientes del programa de vía rápida en cirugía cardiaca electiva. También se analizaron la estancia hospitalaria, mortalidad, complicaciones y reingresos. Métodos: De marzo de 2004 a febrero de 2009 incluimos pacientes adultos con indicación de cirugía cardiaca y con riesgo quirúrgico de bajo a intermedio, con requisitos preoperatorios completos antes del internamiento. Resultados: De un total de 598 pacientes ingresados al programa, se analizaron 533, con edad de 47 ± 14 años, 62.5% mujeres. Se clasificaron en cuatro grupos: valvulares (68%), congénitos (25%), isquémicos (5%) y mixtos (2%). Los promedios de días de estancia hospitalaria fueron: preoperatoria 1.9, terapia tres, postoperatoria en piso 6.9 y total 11.9 días. Se evidenció que 17.8 % estuvieron más de 14 días por: reoperaciones, complicaciones pulmonares, arritmias, o infecciones. La mortalidad fue de 4.1% y hubo 2.8% de reingresos en los primeros tres meses posteriores a la cirugía. Conclusiones: Este programa conduce a bajos índices de mortalidad, estancia hospitalaria y reingresos.
Background: In 1999 so as to decrease the list of cardiac surgery the "fast track" program was started for patients with very mortality low risk. In 2004, this program was extended to moderate risk patients. Objectives: A prospective, descriptive study to evaluate the clinical and demographic characteristics of "fast track" program patients for elective cardiac surgery. We also analyzed the hospital stay, mortality, complications and readmissions. Methods: From March 2004 to February we included adult patients with indications for cardiac surgery, low to intermediate risk of mortality and complete preoperative requirements. Results: From a total of 598 patients, 533 were analyzed, aged 47±14 years, 62.5% female. They were classified in four groups: valvular (68%), congenital (25%), coronary artery disease (5%), and mixed (2%). The average hospital stay was: preoperative 1.9, intensive care unit three, postoperative in hospitalization 6.9 and total 11.9 days. We found that 17.8% had a hospital stay longer than 14 days due to: reoperations, pulmonary complications, arrhythmias or infections. The mortality was 4.1 and 2.8% had readmissions three months after surgery. Conclusions: This program shows a low rate of mortality, hospital stay and readmissions.