scholarly journals Precision implementation of early ambulation in elderly patients underwent off-pump coronary artery bypass graft surgery: a randomized controlled clinical trial

2020 ◽  
Author(s):  
Zhaomei Cui ◽  
Na Li ◽  
Yiou Fan ◽  
Xin Zhuang ◽  
Jing Liu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Artery Bypass Graft ◽  
Early Ambulation ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
To Receive

Abstract Background Though early ambulation (EA) is associated with improved outcomes for post-operative patients, precision initiative on EA for elderly patients has rarely been reported. The aim of this study is to determine the safety and effectiveness of precision implementation of EA in elderly patients underwent off-pump coronary artery bypass graft (OPCABG) surgery. Methods We conducted a single-center, randomized and controlled clinical trial involving elderly patients(≥60 years) in who EA support was implemented after OPCABG surgery. Patients were randomly assigned to precision early ambulation (PEA) group or routine ambulation (Control) group. Innovatively referring age-predicted maximal heart rate (APMHR) and VO 2max was the highlight of PEA. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-point included 90-day mortality, laboratory test, length of stay in ICU, the incidence of multiple organ complications as well as post-traumatic stress disorder (PTSD). Results There were 178 patients were enrolled, with 89 patients assigned to receive PEA and 89 to receive control procedure. By intent-to-treat analysis, during PEA program, participants performed a much longer distance of ambulation on the third day ( P =0.000). Mild-to-moderate physical activity in PEA group ameliorates PLOS ( P =0.031), Time of first bowel ( P =0.000) and partial pressure O 2 ( P g =0.001). Additionally, patients in PEA group showed significantly lower incidence of PTSD than those in Control group ( P =0.000). Conclusion APMHR and VO 2max are valuable for target intensity and exercise formula. PEA after OPCAPG surgery is safe and reliable for elderly patients, which not only reduces the hospital stay but also improves patients’ postoperative functional status.

scholarly journals Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhaomei Cui ◽  
Na Li ◽  
Chaonan Gao ◽  
Yiou Fan ◽  
Xin Zhuang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Early Discharge ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Post Traumatic Stress ◽  
Early Ambulation ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Abstract Background Although early ambulation (EA) is associated with improved outcomes in post-operative patients, implementation of EA in elderly patients is still a challenge. In this study, we aimed to design and assess a precision early ambulation program for cardiac rehabilitation. Methods We conducted a single-center, randomized and controlled clinical trial in elderly patients aged over 60 years after off-pump coronary artery bypass graft (OPCABG) surgery. Patients were randomly assigned to a precision early ambulation (PEA) group or a routine ambulation (Control) group. Age-predicted maximal heart rate (APMHR) and maximal oxygen uptake (VO2max) were used as a reference to formulate and monitor the PEA regimen. The primary end-point was the postoperative length of stay in hospital (PLOS). The secondary end-points included 90-day mortality, incidence of early discharge, laboratory tests, length of ICU stay, the incidence of multiple organ complications and post-traumatic stress disorder (PTSD). Ambulation outcomes were also recorded. Results In total, 178 patients were enrolled (n = 89 per group). In the intent-to-treat analysis, PLOS in the PEA group was shorter than that in the Control group (9.04 ± 3.08 versus 10.09 ± 3.32 days, respectively. Mean difference 1.045 days; 95% confidence interval [CI] 0.098–1.992; P = 0.031 in the unadjusted model; mean difference 0.957 days; CI 0.007–1.907; P = 0.048 in adjusted model). The incidence of early discharge differed significantly between the PEA and control groups (41[46.1%] versus 24[27.0%] patients, respectively. Odds ratio [OR] 0.432; CI 0.231–0.809; P = 0.009 in unadjusted model; OR 0.466; CI 0.244–0.889, P = 0.02 in adjusted model). The time of first bowel movement, partial pressure O2 and post-traumatic stress disorder score in the PEA group were better than those in the Control group. Participants walked much longer distances on day 3 in the PEA group than those in the Control group (76.12 ± 29.02 versus 56.80 ± 24.40 m, respectively, P < 0.001). Conclusion APMHR and VO2max are valuable for implementation of PEA according to an established security threshold. PEA after OPCAPG surgery is safe and reliable for elderly patients, not only reducing the hospital stay, but also improving their physiological and psychological symptoms. Trial registration This study is a component of a protocol retrospectively registered: Application of ERAS in cardiovascular surgery. Trial registration number: ChiCTR1800018167. Date of registration: 3rd September, 2018. URL of trial registry record: http://www.chictr.org.cn/index.aspx

The Validity of Euro Score in Patients who underwent off pump coronary artery bypass graft

2013 ◽  
Vol 2 (6) ◽  
Author(s):  
M. Hadadzade ◽  
S. Forouzania ◽  
S. Mirhoseini ◽  
H. Peighambari ◽  
N. Naserzade ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals On Pump Coronary Artery Bypass Graft Surgery Versus Off Pump Coronary Artery Bypass Graft Surgery: A Review

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
Muhammad Shahzeb Khan ◽  
Mohammad Yousuf-ul Islam ◽  
Muhammad Umer Ahmed ◽  
Faizan Imran Bawany ◽  
Asadullah Khan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals Outcome of off-pump coronary artery bypass graft (OPCAB) surgery: Analysis of 129 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 23-25
Author(s):  
AKM Manzurul Alam ◽  
Istiaq Ahmed ◽  
Manzil Ahmed ◽  
Al Mamun Hossain
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Cabg Surgery ◽  
Off Pump ◽  
Opcab Surgery ◽  
Pump Coronary Artery Bypass

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, including Bangladesh. Besides medical and interventional treatment, coronary artery bypass graft (CABG) surgery in an effective modality for the management of a subset of CAD patients. Off-pump coronary artery bypass graft (OPCAB) surgery is a recent modification of conventional CABG surgery, which, like other parts of the world, is being increasingly practiced in Bangladesh. But the outcome of this relatively recent surgical approach in our setting is largely unknown. In this study, the outcomes of 129 cases off-pump CABG surgery done in a tertiary cardiovascular centre and a private institute in Dhaka were analyzed. Majority (67, 54.2%) had triple vessel disease (TVD), while 4 (3.2%) patients had left main disease. One, two and three grafts were used in 17 (13.2%),74 (57.4%) and 38 (29.4%) cases respectively. There was no mortality. Post-operative complications occurred in 17 (13.18%) patients; secondary wound infection in 10 (7.75%) and immediate respiratory distress in 7 (5.43%) cases. Ten (7.75%) patients needed secondary stitches.Bangladesh Heart Journal 2016; 31(1) : 23-25

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