Short‐term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy

Abstract

The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented.

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

“…Sternotomy principally modifies the compliance of the rib cage, which reduces its mobility by more than 80% for up to 7 days after the surgery. This leads to atelectasis, reducing the DynC [8]. CPB may be responsible for changes in the StaC.…”

“…The occurrence of PPCs may also be linked to factors related to anesthesia, such as the type and the time of anesthesia and the agent used [1,7], as well as to surgical factors related to the site of the incision, surgical type and intra-operative mechanical ventilation [1,7,8]. In heart surgeries there may be a necessity to employ cardiopulmonary bypass (CPB); responsible for the development of systemic and pulmonary inflammatory responses with the latter leading to mechanical respiratory dysfunction [9].…”

Avaliação da função pulmonar em crianças e adolescentes no pré e pós-operatório de correção cirúrgica de valvulopatia reumática

“…In agreement with our results, these authors concluded that FVC and PEF, among other parameters that were analyzed, were significantly reduced after surgery, and, although the exhibited discrete increases over time, were still affected an average of 3.5 months after surgery. Similarly, a further two studies also assessed FVC after heart surgery, concluding that FVC was significantly reduced until POD 7 23 and 8, 20 when compared with preoperative levels.…”

“…Some other studies have also demonstrated varying degrees of pulmonary dysfunction over the short term after heart surgery, although the age groups involved were different. 23,24 * p < 0.01 FVC = forced vital capacity; POD = postoperative day. On the first day after surgery a sudden and significant drop in mean VE was observed and this was maintained until postoperative day three.…”

“…Several different studies demonstrated the potential of cardiac surgery to compromise PF, [19][20][21][22][23] although such studies are scarce for the pediatric population. [24][25][26] To the extent of our knowledge, this is the only study to have monitored the daily progress of PF over the first few postoperative days and compared it to preoperative baseline values.…”