Respiratory movements are altered three months and one year following cardiac surgery

Kristjansdottir, Asdis; Ragnarsdóttir, María; Hannesson, Pétur; Beck, Hans Jakob; Torfason, Bjarni

doi:10.1080/14017430410028492

Cited by 47 publications

(35 citation statements)

References 17 publications

(25 reference statements)

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“…Important deleterious alterations of pulmonary function have been described after CABG (4). In agreement with our study, Kristjánsdóttir et al (23) observed that CABG resulted in rib cage movements and BP worsening, as previously observed with an instrument measuring respiratory movements. Atelectasis has been reported to occur after the onset of general anesthesia and the cardiopulmonary bypass may markedly contribute to an inflammatory reaction in the lungs and postoperative atelectasis (24)(25)(26)(27).…”

Section: Discussionsupporting

confidence: 82%

Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

Pantoni

Thommazo

Mendes

et al. 2011

Braz J Med Biol Res

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Section: Discussionsupporting

confidence: 82%

Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

Pantoni

Thommazo

Mendes

et al. 2011

Braz J Med Biol Res

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“…Alterations in pulmonary function after cardiac surgery were observed in this study, in agreement with other findings, which supports that a reduction in functional residual capacity (FRC) 27 , VC, 13,14,23,28,29 and expiratory flows 11,13,14 occurs following cardiac surgery. According to published studies, the FVC presents a general reduction for a minimum period of 10 to 14 days.…”

Section: Discussionsupporting

confidence: 82%

“…7,8 In spite of modernization of procedures, cardiac surgery can damage pulmonary function, with decreases of respiratory muscle strength and spirometric measurements occurring postoperatively, in addition to the occurrence of atelectasis in more than 90% of the patients. 9 Reduction in oxygenation, 10 pulmonary function, 11,12,13,14 and respiratory muscle strength, 4,5,9,12 as well as radiological changes such as atelectasis 8,12,15 have been cited as common alterations in postoperative cardiac surgery. The reduction of respiratory muscle strength, resulting from direct or indirect lesion of respiratory muscles during surgery and the secondary diaphragmatic dysfunction due to phrenic nerve lesion, has also been related to reduced pulmonary function tests, worsened gas exchange, and increase in the rate of pulmonary complications.…”

mentioning

confidence: 99%

The Influences of Positive End Expiratory Pressure (Peep) Associated With Physiotherapy Intervention in Phase I Cardiac Rehabilitation

Borghi‐Silva

Mendes

Costa

et al. 2005

Clinics

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PURPOSE:To evaluate the effects of positive end expiratory pressure and physiotherapy intervention during Phase I of cardiac rehabilitation on the behavior of pulmonary function and inspiratory muscle strength in postoperative cardiac surgery. METHODS: A prospective randomized study, in which 24 patients were divided in 2 groups: a group that performed respiratory exercises with positive airway expiratory pressure associated with physiotherapy intervention (GEP, n = 8) and a group that received only the physiotherapy intervention (GPI, n = 16). Pulmonary function was evaluated by spirometry on the preoperative and on the fifth postoperative days; inspiratory muscle strength was measured by maximal inspiratory pressure on the same days. RESULTS: Spirometric variables were significantly reduced from the preoperative to the fifth postoperative day for the GPI, while the GEP had a significant reduction only for vital capacity (P < .05). When the treatments were compared, smaller values were observed in the GPI for peak flow on the fifth postoperative day. Significant reductions of maximal inspiratory pressure from preoperative to the first postoperative day were found in both groups. However, the reduction in maximal inspiratory pressure from the preoperative to the fifth postoperative day was significant only in the GPI (P < .05). CONCLUSIONS: These data suggest that cardiac surgery produces a reduction in inspiratory muscle strength, pulmonary volume, and flow. The association of positive expiratory pressure with physiotherapy intervention was more efficient in minimizing these changes, in comparison to the physiotherapy intervention alone. However, in both groups, the pulmonary volumes were not completely reestablished by the fifth postoperative day, and it was necessary to continue the treatment after hospital convalescence. Cardiac surgery reverts symptoms for individuals with specific cardiopathologies and measurably increases their chances of survival and quality of life.1-3 However, pulmonary complications are quite frequent and represent an important cause of morbidity and mortality for patients undergoing cardiac surgery with cardiopulmonary bypass. 2,[4][5][6] These patients can develop various degrees of a systemic inflammatory response syndrome due to factors such as surgical trauma, contact of blood with nonendothelial surfaces of the bypass circuit, and alterations known as reperfusion post-cardiopulmonary bypass lesions, mainly affecting the cardiac and pulmonary regions. 2,[4][5][6] In the pulmonary region, there is an increase in extravascular water with alveolar filling caused by inflammatory cells, which leads to the inactivation of the pulmonary surfactant and collapse of some areas, modifying the pulmonary ventilation/perfusion relationship, with resultant

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“…Most of the patients undergoing coronary artery bypass graft surgery do not have major complications (86%) [2]; however, studies have shown that during the first year after surgery, depression and anxiety are frequent [3]. In a study carried out by Kristjánsdóttir et al [4], pulmonary function remains altered in the first year after surgery via sternotomy. Follow-up favors the early identification of possible complications and the consciousness that despite the symptoms improvement, the delivery of health care should be long lasting.…”

Section: Continuity Of Patient Care After Hospital Dischargementioning

confidence: 99%

Cartas ao Editor

2007

Rev Bras Cir Cardiovasc

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Respiratory movements are altered three months and one year following cardiac surgery

Abstract: The motor system of the respiratory organs suffers considerable injury from cardiac surgery, which in part at least can explain the restrictive breathing 3 months postoperatively.

Cited by 47 publications

References 17 publications

Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

Effects of different levels of positive airway pressure on breathing pattern and heart rate variability after coronary artery bypass grafting surgery

The Influences of Positive End Expiratory Pressure (Peep) Associated With Physiotherapy Intervention in Phase I Cardiac Rehabilitation

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