2021: Perioperative and critical care year in review for the cardiothoracic surgery team

Preoperative respiratory strength training is feasible and safe and improves pulmonary physiologic capacity in individuals undergoing cardiovascular surgery

“… 3 We also noted that compared to aspirating patients with an ineffective or absent cough response to clear tracheal aspirate, those with an effective cough response to clear tracheal aspirate had reduced rates of pneumonia (0% vs 23%), reintubation (0% vs 29%), mortality (0% vs 9%), and readmission (0% vs 15%); shorter hospital LOS (15 days vs 21 days), and lower cost of care ($93,000 vs $136,000). 3 This latter finding revealed a potential modifiable treatment target, airway clearance physiologic capacity to reduce postoperative aspiration, to target in CS patients undergoing planned procedures in the form of a “prehabilitation” 5 respiratory strength training (RST) program. Although it has not yet been explored in preoperative CS patients, prior research studies in other patient populations with impaired pulmonary function and airway clearance physiologic capacity have demonstrated that an RST program is safe (eg, minimal adverse events) and feasible and improves respiratory muscle strength, cough effectiveness, and swallowing safety.…”