scholarly journals Value of preoperative 6-minute walk test for predicting postoperative pulmonary complications

2015 ◽  
Vol 10 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Warangkana Keeratichananont ◽  
Chokchai Thanadetsuntorn ◽  
Suriya Keeratichananont
Keyword(s):  
Pulmonary Complications ◽  
Walk Test ◽  
Postoperative Pulmonary Complications ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals 6 Minute Walk Test (6-MWT) as a Tool for Predicting Post Operative Pulmonary Complications in Abdominal Surgeries

2021 ◽  
pp. 204-209
Author(s):  
K. Janani ◽  
K. Rajkumaran ◽  
S. Niranjani
Keyword(s):  
Abdominal Surgery ◽  
Pulmonary Complication ◽  
Tertiary Care ◽  
Pulmonary Complications ◽  
Uncontrolled Hypertension ◽  
Walk Test ◽  
Coronary Syndrome ◽  
Six Minute Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

Background: Post operative pulmonary complications (PPC) contribute to increased morbidity and mortality. Thus pre operative assessment is required. Six minute walk test (6-MWT) is a simple and reliable test which is recently being included in pre operative evaluation. Objectives: The objective of this study is to determine the value of the six minute walk test as a reliable tool in detecting post operative pulmonary complications in patients undergoing abdominal surgery. Materials and Methods: It is a prospective observational study conducted in a tertiary care centre for a period of 3 months. 66 patients in the age group of 40-60 years undergoing elective abdominal surgery under general anaesthesia were included in this study based on universal sampling method. Patients with recent coronary syndrome, uncontrolled hypertension, cardiac diseases, pregnancy and conditions which impair walking (eg. Arthiritis) were excluded from the study.     6 minute walk test was performed before the surgery. The procedure was explained to the patients and consent was obtained. The test was conducted on a flat surface of 20m near our pre anaesthetic clinic and the patient was asked to walk for a period of 6 minutes in their own comfortable pace. The distance covered by the patients in the 6 minutes was noted. Vitals such a SpO2, heart rate, systolic and diastolic blood pressures were recorded before and after the test. The patients were followed up for the development of pulmonary complications in the post operative period. Results: Out of the 66 patients included in the study, 35 patients did not develop        PPC (Group 1) and 31 patients developed PPC (Group2) including one death due to respiratory failure. The six minute walk distance in the PPC group was significantly less (p=0.0001) when compared to that of the non PPC group. Patients in the PPC group also required prolonged hospital stay. Pneumonia was the most commonly developed post operative pulmonary complication. Conclusion: Six minute walk test is a useful tool in predicting post operative pulmonary complication in patients undergoing abdominal surgery.  

scholarly journals Six minute walk test for predicting postoperative pulmonary complications in high risk patients undergoing major abdominal elective surgery

2021 ◽  
Vol 8 (3) ◽  
pp. 418-421
Author(s):  
Payal P Prajapati ◽  
Pancham H Mehta ◽  
Aniket Aghara ◽  
Kamla H Mehta
Keyword(s):  
High Risk ◽  
Abdominal Surgery ◽  
General Anaesthesia ◽  
Pulmonary Complications ◽  
Walk Test ◽  
Postoperative Pulmonary Complications ◽  
Walk Distance ◽  
Risk Patients ◽  
Minute Walk Distance ◽  
Minute Walk

The morbidity and mortality of patients are increased when postoperative pulmonary complications occurs. To prevent postoperative pulmonary complications, thorough preoperative cardiopulmonary functional assessment is required.To study was the preoperative 6-minute walk test (6MWT) and to determine the association of 6 minute walk distance with postoperative pulmonary complications (PPC) in patients undergoing elective abdominal surgery under general anaesthesia. The study was done in 60 adult high risk patients who were undergoing planned elective abdominal surgery under general anaesthesia. Patients having acute coronary disease, NYHA IV, unable to walk etc. were excluded. Preoperatively 6MWT was conducted according to the American Thoracic Society guidelines and patients were observed for PPC until they discharged from the hospital or died. Statistical analysis was done using SPSS software A total of 60 patients were recruited into the study. 6MWT was done completely in all cases without any complications. Out of the 60 patients, 32 patients had no PPC (group 1) and 28 patients had PPC (group 2). The 6MWD of group with PPCs was significantly less (344 ± 61.927 m) compared to the group without PPCs (442.28 ± 83.194 m, P value = 0.001). The cut off 6MWD obtained was 390 m, which correlated with longer duration of hospital stay and ICU stay (P = 0.001).A multiple regression analysis showed elderly, smoker and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. 6MWT is a reliable predictor of postoperative pulmonary complications with a cutoff 6MWD of 390m in the high risk elderly patients posted for upper abdominal surgery patients.

Direct Myocardial Implantation of Human Fetal Stem Cells in Heart Failure Patients: Long-term Results

2010 ◽  
Vol 13 (1) ◽  
pp. 31 ◽  
Author(s):  
Federico Benetti ◽  
Ernesto Pe�herrera ◽  
Teodoro Maldonado ◽  
Yan Duarte Vera ◽  
Valvanur Subramanian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cells ◽  
Cardiac Function ◽  
Nyha Class ◽  
Left Ventricular ◽  
Long Term Results ◽  
Walk Test ◽  
The Mean ◽  
6 Minute Walk Test ◽  
Minute Walk

Background: End-stage heart failure (HF) is refractory to current standard medical therapy, and the number of donor hearts is insufficient to meet the demand for transplantation. Recent studies suggest autologous stem cell therapy may regenerate cardiomyocytes, stimulate neovascularization, and improve cardiac function and clinical status. Although human fetal-derived stem cells (HFDSCs) have been studied for the treatment of a variety of conditions, no clinical studies have been reported to date on their use in treating HF. We sought to determine the efficacy and safety of HFDSC treatment in HF patients.Methods and Results: Direct myocardial transplantation of HFDSCs by open-chest surgical procedure was performed in 10 patients with HF due to nonischemic, nonchagasic dilated cardiomyopathy. Before and after the procedure, and with no changes in their preoperative doses of medications (digoxin, furosemide, spironolactone, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, betablockers), patients were assessed for New York Heart Association (NYHA) class, performance in the exercise tolerance test (ETT), ejection fraction (EF), left ventricular end-diastolic dimension (LVEDD) via transthoracic echocardiography, performance in the 6-minute walk test, and performance in the Minnesota congestive HF test. All 10 patients survived the operation. One patient had a stroke 3 days after the procedure, and although she later recovered, she was unable to perform the follow-up tests. Another male patient experienced pericardial effusion 3 weeks after the procedure. Although it resolved spontaneously, the patient abandoned his control tests and died 5 months after the procedure. An autopsy of the myocardium suggested that new young cells were present in the cardiomyocyte mix. At 40 months, the mean (SD) NYHA class decreased from 3.4 0.5 to 1.33 0.5 (P = .001); the mean EF increased 31%, from 26.6% 4% to 34.8% 7.2% (P = .005); and the mean ETT increased 291.3%, from 4.25 minutes to 16.63 minutes (128.9% increase in metabolic equivalents, from 2.46 to 5.63) (P < .0001); the mean LVEDD decreased 15%, from 6.85 0.6 cm to 5.80 0.58 cm (P < .001); mean performance in the 6-minute walk test increased by 43.2%, from 251 113.1 seconds to 360 0 seconds (P = .01); the mean distance increased 64.4%, from 284.4 144.9 m to 468.2 89.8 m (P = .004); and the mean result in the Minnesota test decreased from 71 27.3 to 6 5.9 (P < .001).Conclusion: Although these initial findings suggest direct myocardial implantation of HFDSCs is feasible and improves cardiac function in HF patients at 40 months, more clinical research is required to confirm these observations.

Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure

2020 ◽  
Vol 28 (3) ◽  
pp. 290-299
Author(s):  
Kira A. Ageeva ◽  
Evgenii V. Filippov
Keyword(s):  
Respiratory System ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Walk Test ◽  
Ventricular Ejection Fraction ◽  
6Mwt Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

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