Preoperative therapy restores ventilatory parameters and reduces length of stay in patients undergoing myocardial revascularization

Moises Teixeira Sobrinho, Gabriel Negretti Guirado, Marcos Augusto de Moraes Silva, Moises Teixeira Sobrinho, Gabriel Negretti Guirado, Marcos Augusto de Moraes Silva

Abstract

Introduction: The frequency of surgical procedures has increased steadily in recent decades, including the myocardial revascularization.

Objectives: To demonstrate the importance of physiotherapy in the preoperative period of cardiac surgery in relation to the reduction of hospital stay, changes in lung volumes and respiratory muscle strength.

Methods: We conducted a prospective study with patients undergoing myocardial revascularization, the Hospital das Clínicas da Universidade Estadual Paulista (UNESP)/Botucatu - SP. We evaluated 70 patients of both genders, aged between 40 and 75 years, subdivided into two groups: group I - 35 patients of both genders, who received a written protocol guidance, breathing exercises and respiratory muscle training in the preoperative period and group II - 35 patients of both genders, who received only orientation of the ward on the day of surgery. This study was approved by the Ethics Committee of UNESP / Botucatu - SP.

Results: Maximal inspiratory pressure in third postoperative day and fifth postoperative day and significant difference between groups, being better for the intervention group. Expiratory pressure was significant in fifth postoperative day in the intervention group compared to controls. The difference of length of hospital stay in the postoperative was found between the groups with shorter hospital stay in the group receiving preoperative therapy.

Conclusion: Physical therapy plays an important role in the preoperative period, so that individuals in the intervention group more readily restored the parameters evaluated before surgery, in addition, there was a decrease in the time of the postoperative hospital stay. Thus, it is thought the cost-effectiveness of a program of preoperative physiotherapy.

Figures

Fig. 1
Fig. 1
Characterization of groups by gender
Fig. 2
Fig. 2
Median maximum inspiratory pressure (MIP) variable in different moments of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 3

Median for maximum expiratory pressure…

Fig. 3

Median for maximum expiratory pressure (MEP) variable at different times of the operation…

Fig. 3
Median for maximum expiratory pressure (MEP) variable at different times of the operation in the different groups. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 4

Median minute volume (VM )…

Fig. 4

Median minute volume (VM ) variable at different times of the operation of…

Fig. 4
Median minute volume (VM ) variable at different times of the operation of each group analyzed. Friedman test for comparison of the moments in each group and the Mann Whitney test for comparison between groups at any time, *P

Fig. 5

Median tidal volume variable at…

Fig. 5

Median tidal volume variable at different times for the group treated with preoperative…

Fig. 5
Median tidal volume variable at different times for the group treated with preoperative physiotherapy and without physical therapy preoperatively. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 6

Median variable respiratory rate at…

Fig. 6

Median variable respiratory rate at different times of the operation of each group…

Fig. 6
Median variable respiratory rate at different times of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P
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References
    1. Pires AC, Breda JB. Sarmento GJV. Fisioterapia respiratória nos pacientes críticos. Rotinas clínicas. São Paulo: Manole; 2007. Cirurgia cardíaca em adultos; pp. 339–348.
    1. Vilas Boas AG, Perondini GB, Sperandio PCA, Kawauchi TS. Umeda IIK. Manual de fisioterapia na reabilitação cardiovascular. São Paulo: Manole; 2006. Fisioterapia e fatores de risco da doença cardiovascular; pp. 1–40.
    1. Silva LHF, Nascimento CS, Viotti AP., Jr Revascularização do miocárdio em idosos. Rev Bras Cir Cardiovasc. 1997;12(2):132–140.
    1. Blattner C, Saadi EK. O papel da fisioterapia respiratória precoce na evolução de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Fisioter Bras. 2007;8(1):53–56.
    1. Polanczyk CA. Fatores de risco cardiovascular no Brasil: os próximos 50 anos. Arq Bras Cardiol. 2005;84(3):199–201. - PubMed
Show all 21 references
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Fig. 3
Fig. 3
Median for maximum expiratory pressure (MEP) variable at different times of the operation in the different groups. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 4

Median minute volume (VM )…

Fig. 4

Median minute volume (VM ) variable at different times of the operation of…

Fig. 4
Median minute volume (VM ) variable at different times of the operation of each group analyzed. Friedman test for comparison of the moments in each group and the Mann Whitney test for comparison between groups at any time, *P

Fig. 5

Median tidal volume variable at…

Fig. 5

Median tidal volume variable at different times for the group treated with preoperative…

Fig. 5
Median tidal volume variable at different times for the group treated with preoperative physiotherapy and without physical therapy preoperatively. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 6

Median variable respiratory rate at…

Fig. 6

Median variable respiratory rate at different times of the operation of each group…

Fig. 6
Median variable respiratory rate at different times of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P
Similar articles
Cited by
References
    1. Pires AC, Breda JB. Sarmento GJV. Fisioterapia respiratória nos pacientes críticos. Rotinas clínicas. São Paulo: Manole; 2007. Cirurgia cardíaca em adultos; pp. 339–348.
    1. Vilas Boas AG, Perondini GB, Sperandio PCA, Kawauchi TS. Umeda IIK. Manual de fisioterapia na reabilitação cardiovascular. São Paulo: Manole; 2006. Fisioterapia e fatores de risco da doença cardiovascular; pp. 1–40.
    1. Silva LHF, Nascimento CS, Viotti AP., Jr Revascularização do miocárdio em idosos. Rev Bras Cir Cardiovasc. 1997;12(2):132–140.
    1. Blattner C, Saadi EK. O papel da fisioterapia respiratória precoce na evolução de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Fisioter Bras. 2007;8(1):53–56.
    1. Polanczyk CA. Fatores de risco cardiovascular no Brasil: os próximos 50 anos. Arq Bras Cardiol. 2005;84(3):199–201. - PubMed
Show all 21 references
MeSH terms
LinkOut - more resources
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

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The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Fig. 4
Fig. 4
Median minute volume (VM ) variable at different times of the operation of each group analyzed. Friedman test for comparison of the moments in each group and the Mann Whitney test for comparison between groups at any time, *P

Fig. 5

Median tidal volume variable at…

Fig. 5

Median tidal volume variable at different times for the group treated with preoperative…

Fig. 5
Median tidal volume variable at different times for the group treated with preoperative physiotherapy and without physical therapy preoperatively. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 6

Median variable respiratory rate at…

Fig. 6

Median variable respiratory rate at different times of the operation of each group…

Fig. 6
Median variable respiratory rate at different times of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P
Similar articles
Cited by
References
    1. Pires AC, Breda JB. Sarmento GJV. Fisioterapia respiratória nos pacientes críticos. Rotinas clínicas. São Paulo: Manole; 2007. Cirurgia cardíaca em adultos; pp. 339–348.
    1. Vilas Boas AG, Perondini GB, Sperandio PCA, Kawauchi TS. Umeda IIK. Manual de fisioterapia na reabilitação cardiovascular. São Paulo: Manole; 2006. Fisioterapia e fatores de risco da doença cardiovascular; pp. 1–40.
    1. Silva LHF, Nascimento CS, Viotti AP., Jr Revascularização do miocárdio em idosos. Rev Bras Cir Cardiovasc. 1997;12(2):132–140.
    1. Blattner C, Saadi EK. O papel da fisioterapia respiratória precoce na evolução de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Fisioter Bras. 2007;8(1):53–56.
    1. Polanczyk CA. Fatores de risco cardiovascular no Brasil: os próximos 50 anos. Arq Bras Cardiol. 2005;84(3):199–201. - PubMed
Show all 21 references
MeSH terms
LinkOut - more resources
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

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Fig. 5
Fig. 5
Median tidal volume variable at different times for the group treated with preoperative physiotherapy and without physical therapy preoperatively. Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

Fig. 6

Median variable respiratory rate at…

Fig. 6

Median variable respiratory rate at different times of the operation of each group…

Fig. 6
Median variable respiratory rate at different times of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P
Similar articles
Cited by
References
    1. Pires AC, Breda JB. Sarmento GJV. Fisioterapia respiratória nos pacientes críticos. Rotinas clínicas. São Paulo: Manole; 2007. Cirurgia cardíaca em adultos; pp. 339–348.
    1. Vilas Boas AG, Perondini GB, Sperandio PCA, Kawauchi TS. Umeda IIK. Manual de fisioterapia na reabilitação cardiovascular. São Paulo: Manole; 2006. Fisioterapia e fatores de risco da doença cardiovascular; pp. 1–40.
    1. Silva LHF, Nascimento CS, Viotti AP., Jr Revascularização do miocárdio em idosos. Rev Bras Cir Cardiovasc. 1997;12(2):132–140.
    1. Blattner C, Saadi EK. O papel da fisioterapia respiratória precoce na evolução de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Fisioter Bras. 2007;8(1):53–56.
    1. Polanczyk CA. Fatores de risco cardiovascular no Brasil: os próximos 50 anos. Arq Bras Cardiol. 2005;84(3):199–201. - PubMed
Show all 21 references
MeSH terms
LinkOut - more resources
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Fig. 6
Fig. 6
Median variable respiratory rate at different times of the operation of each group analyzed (with and without physical therapy preoperatively). Friedman test for comparison of moments in each group and Mann Whitney test to compare the groups at each time, *P

References

    1. Pires AC, Breda JB. Sarmento GJV. Fisioterapia respiratória nos pacientes críticos. Rotinas clínicas. São Paulo: Manole; 2007. Cirurgia cardíaca em adultos; pp. 339–348.
    1. Vilas Boas AG, Perondini GB, Sperandio PCA, Kawauchi TS. Umeda IIK. Manual de fisioterapia na reabilitação cardiovascular. São Paulo: Manole; 2006. Fisioterapia e fatores de risco da doença cardiovascular; pp. 1–40.
    1. Silva LHF, Nascimento CS, Viotti AP., Jr Revascularização do miocárdio em idosos. Rev Bras Cir Cardiovasc. 1997;12(2):132–140.
    1. Blattner C, Saadi EK. O papel da fisioterapia respiratória precoce na evolução de pacientes submetidos à cirurgia cardíaca com circulação extracorpórea. Fisioter Bras. 2007;8(1):53–56.
    1. Polanczyk CA. Fatores de risco cardiovascular no Brasil: os próximos 50 anos. Arq Bras Cardiol. 2005;84(3):199–201.
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