Pre- and Postoperative Cardiopulmonary Rehabilitation in Hospitalized Patients Undergoing Coronary Artery Bypass Surgery

Herdy, Artur Haddad; Marcchi, Patrícia L. B.; Vila, Adriano; Tavares, Cláudia; Collaço, Jauro; Niebauer, Josef; Ribeiro, Jorge Pinto

doi:10.1097/phm.0b013e3181839152

Cited by 175 publications

(154 citation statements)

References 13 publications

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“…Herdy et al [3], in a controlled clinical trial have evaluated the cardiopulmonary rehabilitation which consisted of muscular exercise and ventilation, as well as preoperative and postoperative education for at least 5 days until discharge. As a result, the authors could observe an expressive reduction in pulmonary complications, a significant difference in the incidence of cardiac arrhythmias, and an improved functional capacity measured on the seventh day after surgery using the 6MWT.…”

Section: Discussionmentioning

confidence: 99%

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio

Nery¹,

Martini²,

Vidor

et al. 2010

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio

Nery¹,

Martini²,

Vidor

et al. 2010

Rev Bras Cir Cardiovasc

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“…70 In addition, when patients with coronary artery disease who had to wait in the hospital for coronary artery bypass grafting were randomized into an exercise training group, outcomes were superior to those in the standard care group, because a reduced rate of postoperative complications and shorter hospital stays were observed (Table 2). 71 Nine of the 12 studies reviewed sufficiently investigated the predictive value of preoperative CRF for postoperative complications, and 8 found CRF to be a valid outcome indicator. Fewer studies reported investigating the role of the anaerobic or ventilatory threshold (a submaximal measure of CRF) in this regard, but in the 6 that did so adequately, 4 found it to be helpful in gauging surgical risk.…”

Section: Crf As a Preoperative Predictor Of Surgical Riskmentioning

confidence: 99%

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Ross¹,

Blair²,

Arena³

et al. 2016

Circulation

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1,517

1,507

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ABSTRACT:Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.M ounting evidence over the past 3 decades has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease (CVD) and all-cause mortality, as well as mortality rates attributable to various cancers, especially of the breast and colon/digestive tract. [1][2][3][4] Importantly, improvements in CRF are associated with reduced mortality risk.5 Although CRF is now recognized as an important marker of cardiovascular health, it is currently the only major risk factor not routinely assessed in clinical practice.In 2013, the American Heart Association and the American College of Cardiology jointly released new guidelines for the prevention and treatment of coronary artery disease.6 Although CRF is the fourth-leading risk factor for CVD and has long been established as a significant prognostic marker, 7 it was excluded from the risk calculator. The authors of the guidelines noted that the evidence that CRF would enhance risk classification was inconclusive, and thus, the added contribution of CRF to determine CVD risk was uncertain. There is, however, a large body of epidemiological and clinical evidence demonstrating not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus (T2DM), but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes.

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“…Visando reduzir essas complicações, é necessário identificar os pacientes em risco de complicações pulmonares pós-operatórias e otimizar a terapêutica 2,8 .…”

Section: Discussionunclassified

“…Essa mesma fonte relata que foram realizadas 10.652 cirurgias de revascularização do miocárdio e/ou troca valvar durante o período de janeiro a junho de 2008 em todo o Brasil 1 . Mesmo com todo o avanço tecnológico que visa aumentar e prolongar a qualidade vida dos pacientes submetidos a essa cirurgia, esse procedimento continua sendo de alta complexidade e favorece alterações nas funções pulmonar e periférica 2 .…”

Section: Introductionunclassified

Análise do tempo de ventilação mecânica e internamento em pacientes submetidos a cirurgia cardíaca

et al. 2017

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A total of 69 selected patients were admitted to the ICU and followed until extubation. With this information, it was possible to know the time that they remained in IMV and then how many days they stayed in the ICU until the time of discharge from the unit. Results: Most patients undergoing CS were male (56.5%); the mean age was 55.93±14.29 years; the most prevalent type of surgery was myocardial revascularization (71.0%); the average time of cardiopulmonary bypass (CPB) was 65.05±20.06 minutes; the average length of stay in ICU was 2.18±1.10 days; the IMV time was 7.32±2.66 hours. There was no statistical significance between these two last variables with p=0.43. Conclusion: It can be concluded that there was no correlation between the duration of mechanical ventilation and ICU length of stay in patients without immediate postoperative complications and who spent less than 12 hours of mechanical ventilation.

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Pre- and Postoperative Cardiopulmonary Rehabilitation in Hospitalized Patients Undergoing Coronary Artery Bypass Surgery

Abstract: Pre- and postoperative cardiopulmonary rehabilitation in patients who await CABG in the hospital is superior to standard care and leads to a reduced rate of postoperative complications and shorter hospital stay.

Cited by 175 publications

References 13 publications

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio

Alterações na capacidade funcional de pacientes após dois anos da cirurgia de revascularização do miocárdio

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association

Análise do tempo de ventilação mecânica e internamento em pacientes submetidos a cirurgia cardíaca

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