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Lung Function Before and Two Days After Open-Heart Surgery
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
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2012 (English)In: Critical Care Research and Practice, ISSN 2090-1313, Article ID:-291628 p.Article in journal (Refereed) Published
Abstract [en]

Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairmenthas been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n = 107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI > 25 had lower postoperative inspiratory capacity (IC) (33% ± 14% pred.) than normalweight patients (39% ± 15% pred.), (P = 0.04).More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r = 0.33, P = 0.001; FEV1: r = 0.35, P ≤ 0.0001; IC: r = 0.25, P = 0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.

Place, publisher, year, edition, pages
2012. Article ID:-291628 p.
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-187856DOI: 10.1155/2012/291628OAI: oai:DiVA.org:uu-187856DiVA: diva2:575738
Available from: 2012-12-11 Created: 2012-12-11 Last updated: 2013-02-14Bibliographically approved
In thesis
1. Lung Function, Respiratory Muscle Strength and Effects of Breathing Exercises in Cardiac Surgery Patients
Open this publication in new window or tab >>Lung Function, Respiratory Muscle Strength and Effects of Breathing Exercises in Cardiac Surgery Patients
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Breathing exercises are widely used after cardiac surgery. The duration of exercises in the immediate postoperative period is not fully evaluated and only limited data regarding the effects of home-based breathing exercises after discharge from hospital have been published.

Aim: The overall aim of this thesis was to evaluate the effects of deep breathing exercises with positive expiratory pressure (PEP) and describe lung function and respiratory muscle strength in patients undergoing cardiac surgery.

Participants and settings: Adult participants (n=131) were randomised to perform either 30 or 10 deep breaths with PEP per hour during the first postoperative days (Study I): the main outcome was oxygenation, assessed by arterial blood gases, on the second postoperative day. In Study III, 313 adult participants were randomly assigned to perform home-based deep breathing exercises with PEP for two months after surgery or not to perform breathing exercises with PEP after the fourth to fifth postoperative day. The main outcome was lung function, assessed by spirometry, two months after surgery. Studies II and IV were descriptive and correlative and investigated pre and postoperative lung function, assessed by spirometry, and respiratory muscle strength, assessed by maximal inspiratory pressure, and maximal expiratory pressure.

Results: On the second postoperative day, arterial oxygen tension (PaO2) and arterial oxygen saturation (SaO2) was higher in the group randomised to 30 deep breaths with PEP hourly. There was no improved recovery of lung function in participants performing home-based deep breathing exercises two months after cardiac surgery, compared to a control group. Subjective experience of breathing or improvement in patient perceived quality of recovery or health-related quality of life did not differ between the groups at two months. Lung function and respiratory muscle strength were in accordance with predicted values before surgery. A 50% reduction in lung function was shown on the second postoperative day. High body mass index, male gender and sternal pain were associated with decreased lung function on the second postoperative day. Two months postoperatively, there was decreased lung function, but respiratory muscle strength had almost recovered to preoperative values.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 58 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 857
Keyword
Breathing exercises, Cardiac surgery, Deep breathing, Lung function, Oxygenation, Physical therapy, Positive expiratory pressure, Spirometry, Respiratory muscle strength
National Category
Physiotherapy
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-192208 (URN)978-91-554-8580-1 (ISBN)
Public defence
2013-03-01, B:42, BMC, Husargatan 3, Uppsala, 09:15 (Swedish)
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Note

Available from: 2013-02-08 Created: 2013-01-17 Last updated: 2013-02-14

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Urell, CharlotteWesterdahl, ElisabethHedenström, HansJanson, ChristerEmtner, Margareta

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