Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial

Moradian, Seyed Tayeb; Najafloo, Mohammad; Mahmoudi, Hosein; Ghiasi, Mohammad Saeid

doi:10.1016/j.jvn.2017.02.001

Cited by 60 publications

(73 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our data also confirmed that PEA promoted gastrointestinal function recovery, with an average reduction of first bowel movement for 0.7 day. In our trial, the occurrence rate of pulmonary atelectasis and pulmonary infection was reduced by 7% and 2% in PEA group, respectively, different form the study of Moradian et al, which showed EA reduced about 34% of pleural effusion and 29% of atelectasis occurrence [25]. Also, we found that arterial oxygen level was significantly improved in PEA group, suggesting that PEA could contribute to lung recovery, and postoperative moderate exercise could improve the circulatory function and muscle tone.…”

Section: Discussioncontrasting

confidence: 75%

“…Another important detailed factor regarding PEA is intensity. Moradian et al has shown that patients received low-frequency monitored exercise programs had higher discharge rates and shorter ICU stay [25]. The expected goal in another study was 100 m of walking with the assistance at second day, and 10-min physiotherapy-supervised walking exercise session at third day after CABG [24].…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial

Cui

Fan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Though early ambulation (EA) is associated with improved outcomes for post-operative patients, precision initiative on EA for elderly patients has rarely been reported. The aim of this study is to determine the safety and effectiveness of precision implementation of EA in elderly patients underwent off-pump coronary artery bypass graft (OPCABG) surgery. Methods We conducted a single-center, randomized and controlled clinical trial involving elderly patients(≥60 years) in who EA support was implemented after OPCABG surgery. Patients were randomly assigned to precision early ambulation (PEA) group or routine ambulation (Control) group. Innovatively referring age-predicted maximal heart rate (APMHR) and VO 2max was the highlight of PEA. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-point included 90-day mortality, laboratory test, length of stay in ICU, the incidence of multiple organ complications as well as post-traumatic stress disorder (PTSD). Results There were 178 patients were enrolled, with 89 patients assigned to receive PEA and 89 to receive control procedure. By intent-to-treat analysis, during PEA program, participants performed a much longer distance of ambulation on the third day ( P =0.000). Mild-to-moderate physical activity in PEA group ameliorates PLOS ( P =0.031), Time of first bowel ( P =0.000) and partial pressure O 2 ( P g =0.001). Additionally, patients in PEA group showed significantly lower incidence of PTSD than those in Control group ( P =0.000). Conclusion APMHR and VO 2max are valuable for target intensity and exercise formula. PEA after OPCAPG surgery is safe and reliable for elderly patients, which not only reduces the hospital stay but also improves patients’ postoperative functional status.

show abstract

Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 97%

Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial

Cui

Fan

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Another important factor regarding early mobilization is the intensity of EA. Moradian et al showed that patients who received low-frequency monitored exercise programs had higher discharge rates and shorter ICU stay [27]. The expected goal in another study was 100 m of walking with assistance on day 2 after CABG, and a 10-min physiotherapy-supervised walking exercise session on day 3 [26].…”

Section: Discussionmentioning

confidence: 99%

Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial

Cui

Gao

et al. 2020

BMC Geriatr

View full text Add to dashboard Cite

Background Although early ambulation (EA) is associated with improved outcomes in post-operative patients, implementation of EA in elderly patients is still a challenge. In this study, we aimed to design and assess a precision early ambulation program for cardiac rehabilitation. Methods We conducted a single-center, randomized and controlled clinical trial in elderly patients aged over 60 years after off-pump coronary artery bypass graft (OPCABG) surgery. Patients were randomly assigned to a precision early ambulation (PEA) group or a routine ambulation (Control) group. Age-predicted maximal heart rate (APMHR) and maximal oxygen uptake (VO2max) were used as a reference to formulate and monitor the PEA regimen. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-points included 90-day mortality, incidence of early discharge, laboratory tests, length of ICU stay, the incidence of multiple organ complications and post-traumatic stress disorder (PTSD). Ambulation outcomes were also recorded. Results In total, 178 patients were enrolled (n = 89 per group). In the intent-to-treat analysis, PLOS in the PEA group was shorter than that in the Control group (9.04 ± 3.08 versus 10.09 ± 3.32 days, respectively. Mean difference 1.045 days; 95% confidence interval [CI] 0.098–1.992; P = 0.031 in the unadjusted model; mean difference 0.957 days; CI 0.007–1.907; P = 0.048 in adjusted model). The incidence of early discharge differed significantly between the PEA and control groups (41[46.1%] versus 24[27.0%] patients, respectively. Odds ratio [OR] 0.432; CI 0.231–0.809; P = 0.009 in unadjusted model; OR 0.466; CI 0.244–0.889, P = 0.02 in adjusted model). The time of first bowel movement, partial pressure O2 and post-traumatic stress disorder score in the PEA group were better than those in the Control group. Participants walked much longer distances on day 3 in the PEA group than those in the Control group (76.12 ± 29.02 versus 56.80 ± 24.40 m, respectively, P < 0.001). Conclusion APMHR and VO2max are valuable for implementation of PEA according to an established security threshold. PEA after OPCAPG surgery is safe and reliable for elderly patients, not only reducing the hospital stay, but also improving their physiological and psychological symptoms. Trial registration This study is a component of a protocol retrospectively registered: Application of ERAS in cardiovascular surgery. Trial registration number: ChiCTR1800018167. Date of registration: 3rd September, 2018. URL of trial registry record: http://www.chictr.org.cn/index.aspx

show abstract

“…Rehabilitasi jantung fase I pasca operasi dimulai hari pertama pasca operasi atau setelah diekstubasi sampai hari kelima pasca operasi (Klopper & Hanekom, 2014;Moradian, et al, 2017). Namun, menurut Borzou, et al (2018) rehabilitasi jantung fase I pasca operasi dimulai 72 jam pasca operasi dan dilanjutkan sampai pasien akan pulang.…”

Section: Waktu Dan Durasi Dilakukan Rehabilitasiunclassified

Intervensi Rehabilitasi Jantung Fase I Pada Pasien Yang Menjalani Operasi Bedah Pintas Koroner (Bpk): Literatur Review

Astuti

Akbar

Nuraeni

2019

Jurnal Keperawatan Indonesia

View full text Add to dashboard Cite

Pasien yang menjalani operasi Bedah Pintas Koroner (BPK) atau coronary artery bypass grafting (CABG) memiliki risiko terjadinya komplikasi pasca operasi yang berakibat pada hari rawat yang lama bahkan kematian. Intervensi berupa rehabilitasi jantung fase I diperlukan untuk membantu mempercepat proses pemulihan pasca operasi serta mencegah terjadinya komplikasi pasca operasi BPK. Meskipun penelitian terkait rehabilitasi jantung sudah banyak dilakukan, namun perlu dilakukan telaah lebih lanjut dari artikel penelitian mengenai intervensi yang dapat dilakukan dalam program rehabilitasi jantung yang aman dan mudah dilakukan pada pasien pasca operasi BPK. Tujuan penelitian ini adalah untuk melihat intervensi yang aman dan efektif dilakukan dalam rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK. Studi literatur ini dibuat dengan melakukan analisis terhadap atikel-artikel ilmiah minimal penelitian retrospektif yang dipublikasi tahun 2008 sampai 2018 dan berbahasa Inggris. Data didapat dari database meliputi Google Scholar, PubMed, DOAJ, dan Proquest dengan kata kunci cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization, education pre operative, dan physical exercise. Hasil studi literatur ini didapatkan 13 artikel yang sesuai dengan kriteria inklusi dan eksklusi. Hasil telaah ditemukan bahwa pelaksanaan rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK dimulai dari fase praoperasi dan dilanjutkan pasca operasi sampai pasien akan pulang. Intervensi rehabilitasi jantung fase I, baik pre maupun pasca operasi, terdiri dari edukasi dan konseling, latihan/ aktivitas fisik, latihan bernapas, latihan batuk efektif, inspiratory muscle training, fisioterapi dada, dan respiratory muscle stretch gymnastics. Oleh karena itu, hasil telaah literatur ini dapat menjadi dasar dalam menentukan standar prosedur operasional terhadap pelaksanaan rehabilitasi jantung fase I untuk rumah sakit yang menyediakan pelayanan operasi BPK. Kata Kunci: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization. Abstract Cardiac rehabilitation phase I in patient undergoing coronary artery bypass grafting surgery. A patient undergoing coronary artery bypass grafting CABG surgery has a risk of post operative complication, which can cause prolonged length of stay and even mortality. The patient necessarily needs to do intervention cardiac rehabilitation phase I to help the recovery process after surgery and prevent post operative complications. The articles related to cardiac rehabilitation have been carried out. However, it is necessary to review research articles about the effective and safe intervention of cardiac rehabilitation phase I for patients undergoing CABG surgery. The aim of this study was to explore the effective and safe intervention of cardiac rehabilitation phase I. This literature review was conducted by analyzing articles including randomized control trial until retrospective design which published between 2008 to 2018 with English language articles. Data was searched through Google Scholar, PubMed, DOAJ, and Proquest. The keyword was early ambulation, coronary artery bypass grafting, preoperative education, physical exercise, early mobilization, and cardiac rehabilitation phase I or inpatient cardiac rehabilitation. The finding in this literature review was 13 articles corresponding with the inclusion and exclusion criteria. The result of this study found that the intervention in cardiac rehabilitation phase I in patient who undergoing coronary artery bypass grafting surgery was started from preoperative and continued postoperative phases until the patient will leave the hospital. Interventions in cardiac rehabilitation phase I consisted of education and counseling, physical exercise/ activity, breathing exercises, effective cough exercises, inspiratory muscle training, chest physiotherapy, and respiratory muscle stretch gymnastics. Therefore, the result of this literature review can be the basis to determine standard operational procedure for the implementation of the cardiac rehabilitation phase I for the hospitals that provide CABG surgery. Keywords: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization

show abstract

Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial

Cited by 60 publications

References 21 publications

Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial

Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial

Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial

Intervensi Rehabilitasi Jantung Fase I Pada Pasien Yang Menjalani Operasi Bedah Pintas Koroner (Bpk): Literatur Review

Contact Info

Product

Resources

About