Preoperative maximal expiratory pressure is associated with duration of invasive mechanical ventilation after cardiac surgery: An observational study

Zanini, Maurice; Nery, Rosane Maria; Bühler, Raquel Petry; Lima, Juliana Beust de; Stein, Ricardo

doi:10.1016/j.hrtlng.2016.01.003

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…Zanini et al . ( 17 ) report that preoperative respiratory rehabilitation was associated with the duration of MV in patients undergoing cardiac surgery. Also, rehabilitation minimized the possibility of MV complication and accelerated the speed of patient recovery ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Respiratory Rehabilitation in Patients Undergoing Cardiac Surgery

Nejkov

Bokan-Mirković

Đukić-Macut³

et al. 2020

ACC

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The aim of the study was to evaluate the effects of preoperative respiratory rehabilitation on functional capacity, length of stay in intensive care unit (ICU), duration of mechanical ventilation (MV) and total hospitalization, as well as to estimate arterial blood gas (ABG) values in patients undergoing cardiac surgery. Nineteen patients were included in the randomized observational study, divided into two groups: group A (intervention) and B (control). Preoperative and postoperative rehabilitation was performed in group A, and only postoperative rehabilitation in group B. Rehabilitation was carried out according to a predefined protocol. We used ABG to evaluate respiratory function, two-minute walk test (2MWT) and sit-to-stand test to assess functional capacity. The following data were obtained from medical documentation: duration of MV, length of stay at ICU, occurrence of postoperative pulmonary complications, and length of total hospitalization in both groups. Significant between-group difference was found for the length of total hospitalization and duration of MV (p<0.05 both). Analysis of the mean values of 2MWT on the last day of hospitalization (p=0.005), sit-to-stand test before surgery (p=0.022) and on the last day of hospitalization (p=0.008) showed statistically significant differences. The length of hospital stay significantly correlated with preoperative rehabilitation in group A (r=0.885; p<0.0001). There was no difference in ABG parameters between the groups. The study showed that preoperative respiratory rehabilitation had an effect on reducing duration of MV and length of total hospitalization, and improved functional capacity.

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Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Respiratory Rehabilitation in Patients Undergoing Cardiac Surgery

Nejkov

Bokan-Mirković

Đukić-Macut³

et al. 2020

ACC

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“…Furthermore, prolonged mechanical ventilation after coronary artery bypass grafting was associated with a reduction in early and mid-term survival. Findings from a study conducted by Zanini et al showed that there was an association between maximal expiratory pressure, which was measured preoperatively as respiratory muscle function, and the duration of invasive mechanical ventilation in patients undergoing coronary artery bypass grafting, valve surgery, and combined procedures [Zanini 2016]. Their study demonstrated that each 1-cm H2O increase in maximal expiratory pressure reduced the duration of invasive mechanical ventilation by approximately 7 minutes.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Assessment of Pulmonary Function Tests and Outcomes After Cardiac Surgery

Fujii

Nishina

Bessho

2020

HSF

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Background: To investigate the association between preoperative pulmonary function evaluations and surgical outcomes of patients with chronic lung disease following cardiac surgery. Methods: This retrospective observational study evaluated 148 patients using preoperative pulmonary function tests before undergoing cardiac surgery. Patients were divided into 4 groups (normal, obstructive, restrictive, and combined disorder), based on the result of the pulmonary function tests. Additionally, we evaluated the percent predicted forced expiratory volume in 1 second. Finally, we investigated the mechanical ventilation duration, length of postoperative hospital stay, and the 30-day mortality rate between the groups in each study. Results: The mechanical ventilation duration and length of postoperative hospital stay in the combined group was significantly longer than that in the other groups (P < .0001, P < .0001, respectively). Patients in the restrictive group had a significantly longer postoperative ventilation or hospitalization than those in the normal group (P = .0479, P = .0164, respectively). However, there were no significant differences in the 30-day mortality rates between the groups. There also was a significant negative correlation between the percent predicted forced expiratory volume in 1 second and mechanical ventilation (R2 = 0.052, P = .0054) and postoperative hospitalization (R2 = 0.042, P = .0122). Conclusion: Risk stratification by preoperative pulmonary function tests may be used to accurately identify the postoperative outcomes in chronic lung disease patients following cardiac surgery.

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“…The association between inspiratory muscle strength and duration of mechanical ventilation is already well established in the literature, with MIP being an accurate predictor of the time for weaning from mechanical ventilation. [15][16][17] A recent similar study 18 with a population of patients undergoing elective cardiac surgery identified only expiratory muscle strength as a predictor of the duration of mechanical ventilation. In that study, high preoperative MEP values were associated with a reduction in the duration of mechanical ventilation.…”

Section: Characteristicsmentioning

confidence: 98%

Preoperative expiratory and inspiratory muscle weakness to predict postoperative outcomes in patients undergoing elective cardiac surgery

Winkelmann¹,

Steffens²,

Windmöller³

et al. 2019

J Card Surg

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Background: Few studies have evaluated preoperative respiratory muscle strength as a risk factor for postoperative morbidity and mortality. The objective of this study was to evaluate the association of preoperative inspiratory muscle weakness (IMW) and preoperative expiratory muscle weakness (EMW) with duration of mechanical ventilation, length of stay in the intensive care unit (ICU), incidence of postoperative pulmonary complications (PPCs), and mortality in patients undergoing elective cardiac surgery. Materials and methods:This was a prospective observational study. Patients admitted for elective cardiac surgery were recruited. Maximal inspiratory and expiratory pressure were measured before surgery. A multivariate regression model was used to adjust for possible confounding variables and test the association of IMW and EMW with the duration of mechanical ventilation, length of stay in the ICU, PPCs, and hospital mortality.Results: Two hundred and fifty-five patients were included in this study. The presence of IMW was associated with an increase in the duration of mechanical ventilation (P = .012). The presence of EMW was associated with a reduction in the incidence of PPCs (P = .005). IMW had no significant association with length of stay in the ICU, PPCs, or hospital mortality. EMW had no significant association with the duration of mechanical ventilation, length of stay in the ICU, or hospital mortality. Conclusions:In patients undergoing elective cardiac surgery, preoperative IMW is associated with the duration of mechanical ventilation while preoperative EMW is associated with a decrease in PPCs.

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Preoperative maximal expiratory pressure is associated with duration of invasive mechanical ventilation after cardiac surgery: An observational study

Cited by 7 publications

References 31 publications

Effect of Preoperative Respiratory Rehabilitation in Patients Undergoing Cardiac Surgery

Effect of Preoperative Respiratory Rehabilitation in Patients Undergoing Cardiac Surgery

Preoperative Assessment of Pulmonary Function Tests and Outcomes After Cardiac Surgery

Preoperative expiratory and inspiratory muscle weakness to predict postoperative outcomes in patients undergoing elective cardiac surgery

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