Chest wall motion and pulmonary function are more diminished following cardiac surgery when the internal mammary artery retractor is used

Abstract

The significantly more reduced ARM and lung volumes 3 months postoperatively in the IMA group than in the Median group suggests that the IMA retractor causes greater injury to the rib cage and the diaphragm.

Measuring breathing patterns and respiratory movements with the respiratory movement measuring instrument

“…RMMI measures bilateral anteroposterior movements of the upper and lower thorax and abdomen using a laser technique. It has been shown to be very sensitive in the measurement of small changes in breathing patterns (Kristjansdottir et al ., ,b; Ragnarsdottir et al ., , ; Johansson et al ., ). The instrument is movable; it does not require a laboratory setting; and it is constructed to measure RMs in different body positions.…”

Effects of osteopathic treatment on pulmonary function and chronic thoracic pain after coronary artery bypass graft surgery (OstinCaRe): study protocol for a randomised controlled trial

“…Although CABG surgery is an effective coronary revascularisation technique, there are a number of postoperative complications, such as diminished pulmonary function and chronic thoracic pain, from which patients are prone to suffer from [10, 11, 14–20]. To our knowledge, there are no effective treatments to treat these conditions or effective preventive interventions [6, 17, 21].…”

“…The protocol used is based on the work of Dickey [31] and supplemented with the findings of other authors [32–35]. The most common findings found in literature are:Decrease in costal mobility [8, 10, 11, 36]Decrease in pulmonary function [6, 8, 10]Decreased thoracic mobility [8, 10, 11, 31]Dysfunction of the abdominal diaphragm [31, 37–41] …”

“…For example, a decrease in pulmonary function is a frequently observed complication after CABG surgery. During the first week after CABG surgery vital capacity (VC) decreases by 30–60% [6–9] and even up to 1 year this remains reduced by 12% [10, 11]. Reduced VC has a negative effect on exercise tolerance (Vo2max) [12] and therefore it is important to optimize pulmonary function after CABG surgery.…”

“…This decreased thoracic mobility was still present 12 months after surgery [11]. Thoracic mobility and vital capacity were affected more when the left internal thoracic artery (LITA)-retractor was used and reduced thoracic mobility is related to a diminished pulmonary function [10]. …”