scholarly journals The possibility of using skeletal muscle electrical stimulation in the rehabilitation of patients after cardiac surgery

2020 ◽  
Vol 8 (4S) ◽  
pp. 70-81
Author(s):  
A. N. Sumin ◽  
P. A. Oleynik ◽  
A. V. Bezdenejnykh
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Period ◽  
Clinical Status ◽  
Early Postoperative Period ◽  
Muscle Performance ◽  
Control Group ◽  
Study Group ◽  
Six Minute Walk Test ◽  
Lower Extremity Muscle ◽  
Minute Walk

Aim. To evaluate the effectiveness of electrical muscle stimulation (EMS) in patients with the complicated early postoperative period after cardiac surgery.Methods. 61 patients (44 men and 17 women) aged 52-70 years with the complicated early postoperative period after cardiac surgery were included in the study. The complications included prolonged length of stay in the intensive care unit and prolonged mechanical ventilation. The initial muscle performance of the lower extremities was measured with the carpal and isokinetic dynamometer in all patients. The six-minute walk test was performed in all patients after they had been transferred to the department of cardiac surgery.Results. Patients in the study group had reduced lower extremity muscle strength at baseline, compared with the control group. After the EMS sessions, the study group patients demonstrated pronounced improvements in muscle performance as compared to the control group. Both knee-joint extension values increased during the isometric contraction as compared to those in the control group (38.8% and 40.0% versus 8.1% and 8.4%, p <0.001), similarly to right knee-joint flexion (23.7% versus 10.1%, p = 0.008), left ankle joint (18.6 versus 4.3%, p = 0.010), right-hand grip strength (18.3 versus 11.1%, p = 0.042). In addition, the six-minute walk test results improved in the EMS group (119.72% (293 meters) and 87.13% (315 meters)) as compared to the control group (p = 0.079).Conclusion. The EMS sessions did not affect the clinical status of cardiac surgical patients with the complicated postoperative period. Moreover, it appeared to be beneficial in terms of the improved lower extremity muscle strength that was more pronounced in the study group than in the control group. Therefore, the effects of EMS on the clinical status of these patients require the further investigation.

scholarly journals Non-Conservative Therapy in the Prevention of Subepithelial Fibroplasia after LASEK Hypermetropia Correction

2018 ◽  
Vol 15 (2) ◽  
pp. 200-206
Author(s):  
S. A. Korotkikh ◽  
A. E. Bogachev ◽  
A. S. Shamkin
Keyword(s):  
Dry Eye ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Study Group ◽  
Postoperative Therapy ◽  
Significant Difference

The results of observation of patients who underwent vision eximerlaser correction by the LASEK method regarding medium degree of hyperopia were analyzed.Purpose:to investigate the severity of the «dry eye» syndrome and corneal subepithelial fibroplasia in patients after laser correction of  hyperopia by the LASEK method, and their prevention by reducing  the preservative action on the eye surface.Patients and methods.The study included 40 patients (76 eyes), aged 21–46 years (32.98 ± 1.79) who underwent LASEK surgery for  moderate hyperopia (4.03 ± 0.38 D). Patients were divided into two  groups: 1) control group (20 patients, 37 eyes) — postoperative  therapy included the corneoprotector “Stilavit®” and the preparation  of hyaluronic acid “Oksial®”, containing preservatives;  2) the study group (20 patients, 39 eyes) — postoperative therapy  included the corneoprotector “Hilozar-comod®” and the artificial tear  preparation “Hilo-comod®”, which did not contain reservatives. Ophthalmic examination included, in addition to standard diagnostic  methods, the Norn test, the Schirmer test, the staining of the eye  surface with lissamine green. In addition, a questionnaire was  conducted on a modified OSDI questionnaire; there a section  characterizing the quality of vision (section B) was removed.Results.The analysis of the obtained data showed that in the study group there was less pronounced “dry eye” syndrome at 3,6,12  months after the operation. The maximum difference in the  indicators of the “dry eye” syndrome between the groups was at 3  and 6 months of the postoperative period. When evaluating corneal  subepithelial fibroplasia, maximum attention was paid to the  frequency and the intensity index. It was shown a significant  difference in the intensity of the haze between the study group and the control group by 26.1 % at 3 months, by 62.2 % at 6  months and by 65.3 % 12 months after the operation. Conclusion.Nonconservative therapy with sodium hyaluronate and  dexapanthenol in the early postoperative period and only sodium  hydrolurate allows to reduce the severity of the dry eye syndrome  after laser correction of hypermetropia and, as a result, to reduce  the intensity of haze development by 65.3 %, and its frequency on 11,5 %.

scholarly journals Effect of Nursing Exercise Protocol on Hemodynamics and Functional Capacity among Patients after Cardiac Surgery

2019 ◽  
Vol 1 (3) ◽  
pp. 14
Author(s):  
Asmaa A. A. Mohamed ◽  
Manal S. Hassan ◽  
Yasser S. M. Mubarak ◽  
Lobna M. Gamal
Keyword(s):  
Cardiac Surgery ◽  
Functional Capacity ◽  
Control Group ◽  
Study Group ◽  
Exercise Protocol ◽  
Walk Distance ◽  
Exercise Interventions ◽  
Total Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Context: Exercise interventions are the cornerstone of cardiac rehabilitation. The exercise program consists of respiratory physiotherapy, neck and shoulder exercises, walking, and cycling. The purpose is preventing respiratory complications, neck and shoulder pain, and increasing the physical functional level. Aim: of this study is to evaluate the effect of applying nursing exercise protocol on hemodynamics and functional capacity among post-cardiac surgery patients. Methods: Quasi-experimental research design utilized in the current study. A purposive sample including 60 male and female patients, classified equally into two equal groups; study group (n= 30) and control group (n= 30), collected through 14 months. This study carried out in the inpatient cardiac surgery department and the outpatient cardiac clinic of Cardiothoracic Surgery Hospital at New Minia City. Four tools utilized in collecting data; named Health Assessment Record; Six Minute Walk Distance Test; Modified Medical Research Council Scale (MMRC) for measuring dyspnea; and Nursing Educational Protocol Checklist. Results: Current study findings displayed an improvement of total distance walked among study group compared to control group, it also showed highly statistically significant differences between both groups related to total distance walked after 12th-week post-discharge documented by p-value (0.000). Conclusion: The current study findings concluded that the nursing educational protocol in the form of deep breathing, incentive spirometer; coughing and early ambulation induces a significant improvement in hemodynamic variables and six minute walk distance recommending that hospitals should implement nursing educational protocol as a routine hospital policy among all cardiac surgical patients in all age groups. 

scholarly journals Tear Film Osmolarity of the Eye after Cataract Surgery. Summary of the Doctoral Thesis

2021 ◽  
Author(s):  
◽  
Ēriks Elksnis ◽  
Keyword(s):  
Cataract Surgery ◽  
Postoperative Period ◽  
Ocular Surface ◽  
Tear Film ◽  
Visual Outcome ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Almost every cataract surgeon has encountered a situation during the postoperative period when, even though, the primary goal – improvement of visual acuity – has been achieved, yet the patient felt frustrated because of subjective discomfort in the operated eye. Sometimes this issue is more disturbing for the patient than the hope for a perfect visual outcome. Although it has been established that the ocular surface is affected during the postoperative period, there is still no generally accepted opinion about the changes in tear osmolarity after cataract surgery despite several studies dedicated to evaluation of these changes. The present study was designed to elucidate the effect of cataract surgery on the characteristic feature of ocular surface homeostasis – tear film osmolarity in the early postoperative period. Aim. The aim of the study was to evaluate the changes in tear film osmolarity after a cataract surgery in a healthy ocular surface. Methods. For this purpose two examination groups were formed. The study group included voluntary patients undergoing cataract surgery not having any complaints about subjective symptoms typical of dry eye disease. In order to correspond to the criteria of healthy ocular surface, the study group excludes the following types of patients and conditions: contact lens wearers, patients with diabetes, pseudoexfoliation, pterygia and eye drop users. The eye that has not undergone the surgery was classified as the control group. This single–center, prospective study was held at Ophthalmology department of Pauls Stradins Clinical university hospital. All cataract surgeries were done by the same surgeon. The tear osmolarity tests were evaluated with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, the USA) before surgery, in the next morning, one week and one month after the surgery. Results. No statistically significant difference was observed between the groups before operation when comparing the mean tear osmolarity – in the study group it was 296.87 mOsm/L, and in the control group it was 297.27 mOsm/L (p = 0.84). The tear osmolarity results changed significantly during early postoperative period in the study group (p < 0.001), while in non–operated eye no significant tear film osmolarity changes were observed (p = 0.86). Significant changes were recognized on the next day after the surgery – the tears became hypoosmolar (< 275 mOsm/L). One week later the tear osmolarity increased significantly, and the tears became hyperosmolar (312.64 mOsm/L). Over the course of one month, the test values for the study and control groups equalized (297.87 in the study group and 298.93 in the control group (p = 0.66)), when compared to preoperative tear osmolarity results. Conclusion. The results achieved lead towards a more detailed understanding of the changes in the ocular surface homeostasis after a cataract surgery. The obtained data indicate that tear osmolarity changes considerably during the first postoperative month after a cataract surgery. Also, there is a huge difference in measurements between operated and non–operated eye on the next day and one week after the surgery. One month after the surgery tear osmolarity returns to preoperative test results, and there is no difference determined between the eyes.

Evaluation of the intraoperative monitoring effectiveness during intramedullary tumors surgery in the early postoperative period

2015 ◽  
Vol 9 (2) ◽  
pp. 0-0
Author(s):  
Федин ◽  
P. Fedin ◽  
Шахпаронова ◽  
N. Shakhparonova ◽  
Гуща ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Intraoperative Monitoring ◽  
Early Postoperative Period ◽  
Activity Level ◽  
Successful Outcome ◽  
Control Group ◽  
Study Group ◽  
Motor Score ◽  
Preoperative Level ◽  
Intramedullary Tumors

Purpose: On the grounds of comprehensive assessment of the 2 groups of patients after intramedullary tumors surgery compare a neurological outcome in the early postoperative period. The first group was operated with intraoperative monitoring and the second group was operated before the introduction of neurophysiological control. During the monitoring try to identify predictors of successful outcome for patients after intramedullary tumors surgery. The study included 48 patients with intramedullary tumors of cervical and thoracic localization. Complex neurological examination was performed before surgery and 2 weeks after surgery and included: as-sessment of neurological status on McCormick Scale, functional outcome rated on SCIM III Scale, the total mobility was evaluated on Rivermid Index mobility and paresis we rated on the ASIA Motor Score scale. The study group consisted of 26 patients operated with intraoperative monitoring and control group consisted of 22 patients operated before the introduction of intraoperative monitoring in neurosurgical practice. The trial comprised patients with a functional status I-III rated on McCormick Scale. After assessing the 2 groups according the SCIM III scale it was found out the persistence of the level in the study group (p=0,044) and a decrease of the final score in the control group. Comparing the activity level on a Rivermid scale we identified improvement in the study group (р=0,034) and retention of activity in the control group. We detected that in the study group where we used intraoperative monitoring, the level of paresis accord-ing to ASIA Motor Score preserve at the preoperative level, and the growth of paresis level in the control group (p&#60;0,05). Preservation of MEP amplitude &#62; 50% at the end of the operation is a predictor of saving muscle strength at the preoperative level. Patients, who underwent surgery with the use of intraoperative monitoring are more active and indepen-dent from outside help in the early postoperative period.

Effect of neuromuscular electrical stimulation on functional exercise capacity in patients undergoing cardiac surgery: A randomized clinical trial

2021 ◽  
pp. 026921552110709
Author(s):  
Telma Cristina Fontes Cerqueira ◽  
Manoel Luiz de Cerqueira Neto ◽  
Lucas de Assis Pereira Cacau ◽  
Amaro Afrânio de Araújo Filho ◽  
Géssica Uruga Oliveira ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Electrical Stimulation ◽  
Postoperative Period ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Functional Independence Measure ◽  
Rectus Femoris ◽  
Functional Independence ◽  
Control Group ◽  
Electromyographic Activity

Objective To evaluate the effects of neuromuscular electrical stimulation on functional capacity of patients in the immediate postoperative period of cardiac surgery. Design A prospective, randomized controlled trial. Setting A cardiac surgery specialist hospital in Aracaju, Sergipe, Brazil. Subjects: Patients in the postoperative period of cardiac surgery. Intervention The control group received the conventional physiotherapy and the intervention group received neuromuscular electrical stimulation of the rectus femoris and gastrocnemius muscles bilaterally, applied for 60 min, twice a day for up to 10 sessions per patient, in the immediate postoperative period until postoperative day 5. Main measures The primary outcome was the distance walked, which was evaluated using the 6-min walk test on postoperative day 5. Secondary outcomes were gait speed, lactate levels, muscle strength, electromyographic activity of the rectus femoris and Functional Independence Measure, some of them evaluated on preoperative and postoperative period. Results Of 132 eligible patients, 88 patients were included and randomly allocated in two groups, and 45 patients were included in the analysis. No significant difference was found on the distance walked ( p = 0.650) between patients allocated in intervention group (239.06 ± 88.55) and control group (254.43 ± 116.67) as well as gait speed ( p = 0.363), lactate levels ( p = 0.302), knee extensor strength ( p = 0.117), handgrip strength ( p = 0.882), global muscle strength ( p = 0.104), electromyographic activity ( p = 0.179) and Functional Independence Measure ( p = 0.059). Conclusions Although the effects are still uncertain, the use of neuromuscular electrical stimulation carried out in five days didn't present any benefit on functional capacity of patients in the immediate postoperative period of cardiac surgery.

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY

2015 ◽  
Vol 7 (4) ◽  
pp. 38-42 ◽  
Author(s):  
A V Sotnikov ◽  
V M Melnikov ◽  
R V Almadi ◽  
G N Gorbunov
Keyword(s):  
Cardiac Surgery ◽  
Wound Infection ◽  
Incidence Rate ◽  
Control Group ◽  
Study Group ◽  
Intravenous Injections ◽  
Deep Wound Infection ◽  
Period 2 ◽  
Deep Wound

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

EVALUATION OF THE EFFECTIVENESS OF A CLOSED CIRCUIT IN COMPARISON WITH AN OPEN CIRCUIT OF CARDIOPULMONARY BYPASS

2021 ◽  
pp. 44-47
Author(s):  
Berik Tuishiev ◽  
Gulzhan Bayzhan ◽  
Sabina Samitova
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Open Circuit ◽  
Closed Circuit ◽  
Control Group ◽  
Study Group ◽  
Valve Insufficiency ◽  
Group 5 ◽  
Group 2

Objective is to evaluate the effectiveness of closed-loop surgeries with the planned duration of cardiopulmonary bypass more than 2 hours in the immediate postoperative period. Materials and methods. A study was carried out in the clinic over 10 patients (average age 47-56 years) with Diagnoses: Ascending aortic aneurysm, FC 3 aortic valve insufficiency, who underwent surgery for ascending aorta replacement, aortic valve replacement with coronary artery reimplantation. The patients were divided into 2 groups, the 1st group (5 patients) is the control group using an open cardiopulmonary bypass circuit, the 2nd group (5 patients) is the patients using a closed cardiopulmonary bypass circuit. The total time of cardiopulmonary bypass in both groups was 125-187 minutes. Results. In the 2nd study group, drainage blood loss significantly decreased, on average 60-100 ml compared to the control group, where the average drainage loss was 600-1500 ml. The need for blood transfusion was 5.1% in the 2nd group, compared with 43.4% in the control group. In the study group 2, the number of platelets in the postoperative period in patients was higher than in the control group. Conclusion. This study shows that a closed circuit, compared to an open one, allows complex heart surgeries with a planned duration of extracorporeal circulation of more than 2-3 hours.

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

Severe Calcification of the Ascending Aorta Detected Incidentally in Patients Undergoing Cardiac Surgery

2019 ◽  
Vol 68 (04) ◽  
pp. 309-314 ◽  
Author(s):  
Mohamed Salem ◽  
Baland Mohammad ◽  
Katharina Huenges ◽  
Christine Friedrich ◽  
Bernd Panholzer ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Adverse Events ◽  
Circulatory Arrest ◽  
Ascending Aorta ◽  
Control Group ◽  
Study Group ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Significant Difference ◽  
Severe Calcification

Background Incidentally discovered severe calcified ascending aorta (CAA) is a major challenge faced by surgeons during cardiac surgery. The aim of this study was to evaluate the outcome in patients undergoing cardiac surgery in this condition with the additional replacement of the CAA. Methods A retrospective study on a cohort of 74 patients (28.4% females; mean age: 73 ± 7 years) underwent cardiac surgery and initial replacement of an incidentally discovered CAA using moderate hypothermic circulatory arrest. A control group was matched according to age, gender, and procedure. Results No significant differences were noted with regard to preoperative risk factors. Due to the additional replacement of CAA, the extracorporeal circulation and cross-clamping time were significantly longer in the study group (p < 0.001). Postoperatively, no significant differences in complications were observed between the groups. There was no significant difference in regard to incidence of neurologic adverse events (5.4 vs. 2.7%; p = 0.68) or 30-day mortality (6.7 vs. 4.1%; p = 0.72). Conclusion Our study showed that the initial replacement of incidental CAA in patients undergoing cardiac surgery was not associated with increased risks for neurologic adverse events and mortality.

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