Rehabilitation Following Open-Heart Surgery — From a Surgeon’s Point of View

Author(s):  
G. Rodewald ◽  
P. Kalmar ◽  
H.-J. Krebber
Symmetry ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 81
Author(s):  
Bogdan Mocan ◽  
Claudiu Schonstein ◽  
Calin Neamtu ◽  
Mircea Murar ◽  
Mircea Fulea ◽  
...  

Following cardiac surgery, patients experience difficulties with the rehabilitation process, often finding it difficult, and therefore lack the motivation for rehabilitation activities. As the number of people aged 65 and over will rise by 207 percent globally by 2050, the need for cardiac rehabilitation will significantly increase, as this is the main population to experience heart problems. To address this challenge, this paper proposes a new robotic exoskeleton concept with 12 DoFs (6 DoFs on each arm), with a symmetrical structure for the upper limbs, to be used in the early rehabilitation of cardiac patients after open-heart surgery. The electromechanical design (geometric, kinematic, and dynamic model), the control architecture, and the VR-based operating module of the robotic exoskeleton are presented. To solve the problem of the high degree of complexity regarding the CardioVR-ReTone kinematic and dynamic model, the iterative algorithm, kinetic energy, and generalized forces were used. The results serve as a complete model of the exoskeleton, from a kinematic and dynamic point of view as well as to the selection of the electric motors, control system, and VR motivation model. The validation of the concept was achieved by evaluating the exoskeleton structure from an ergonomic point of view, emphasizing the movements that will be part of the cardiac rehabilitation.


1979 ◽  
Vol 32 (1-4) ◽  
pp. 148-156 ◽  
Author(s):  
H.-J. Meffert ◽  
B. Dahme ◽  
B. Flemming ◽  
P. Götze ◽  
G. Huse-Kleinstoll ◽  
...  

1983 ◽  
pp. 113-118 ◽  
Author(s):  
P. Tienari ◽  
J. Outakoski ◽  
A. Juolasmaa ◽  
R. Hirvenoja

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.


1967 ◽  
Vol 18 (03/04) ◽  
pp. 634-646 ◽  
Author(s):  
N Thurnherr

SummaryBlood clotting investigations have been executed in 25 patients who have undergone open heart surgery with extracorporeal circulation. A description of alterations in the activity of blood clotting factors, the fibrinolytic system, prothrombin consumption and platelets during several phases of the operation is given.


2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
N Madershahian ◽  
T Wittwer ◽  
J Strauch ◽  
J Wippermann ◽  
UFW Franke ◽  
...  

2015 ◽  
Vol 16 (2) ◽  
pp. 78
Author(s):  
Umit Kervan ◽  
Anil Ozen ◽  
Utku Unal ◽  
Irfan Tasoglu ◽  
Mahmut Mustafa Ulas ◽  
...  

<p><b>Objective:</b> The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery.</p><p><b>Methods:</b> We analyzed free thyroid hormones (FT3 and FT4) and thyroid-stimulating hormones (TSH) in 200 consecutive patients undergoing open heart surgery. Patients were divided into 5 groups according to the inotropic drug administration as follows: Group A (n = 46) received dopamine alone; Group B (n = 40), dopamine and dobutamine; Group C (n = 36), dopamine, dobutamine, and adrenaline; Group D (n = 32), adrenaline alone; and Group E (n = 46), placebo. Procedural factors affecting thyroid hormones were recorded and included cardiopulmonary bypass (CPB) time, cross-clamping time, degree of hypothermia, and the duration and doses of positive inotropic drugs. Blood samples for hormone assays were collected before initiation of inotropic drug therapy (baseline) and postoperatively at 24, 72, and 120 hours after drug therapy.</p><p><b>Results:</b> FT3, FT4, and TSH levels at baseline were similar in all groups. Although there was a trend showing very slight increases in thyroid hormone levels from baseline to the 24th, 72nd, and 120th postoperative hours after drug therapy, these changes were not significant, and there were also no significant differences between the groups. There was also no significant statistical difference in CPB time, cross-clamping time, degree of hypothermia, and duration and doses of positive inotropic drugs between groups.</p><p><b>Conclusion:</b> Although thyroid hormone levels were affected by positive inotropic drug usage after open heart surgery, this effect was not significant and thyroid hormone levels remained within normal ranges.</p>


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