What is the Role of Preoperative Breathing Exercises in Reducing Postoperative Atelectasis after CABG?

2019 ◽  
Vol 14 (4) ◽  
pp. 275-279 ◽  
Author(s):  
Seyed Tayeb Moradian ◽  
Amir Abas Heydari ◽  
Hosein Mahmoudi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Pulmonary Complications ◽  
Artery Bypass Graft ◽  
Breathing Exercises ◽  
Arterial Blood ◽  
Significant Difference

Background: Atelectasis and hypoxemia are frequently reported after coronary artery bypass graft surgery (CABG). Some studies confirm the benefits of breathing exercises on pulmonary complications, but the efficacy of preoperative breathing exercises in patients undergoing CABG is controversial. In this study, the effect of preoperative breathing exercises on the incidence of atelectasis and hypoxemia in patients candidate for CABG was examined. Methods: In a single-blinded randomized clinical trial, 100 patients who were undergoing coronary artery bypass graft surgery were randomly allocated into two groups of experimental and control, each consisted of 50 patients. Before the operation, experimental group patients were enrolled in a protocol including deep breathing, cough and incentive spirometer. In the control group, hospital routine physiotherapy was implemented. All the patients received the hospital routine physiotherapy once a day for 2 to 3 minutes in the first four days postoperatively. Arterial blood gases and atelectasis were compared between groups. Results: There was no significant difference between groups in terms of atelectasis and hypoxemia (p Value>0.05). Conclusion: Preoperative breathing exercise does not reduce pulmonary complications in patients undergoing CABG.

scholarly journals Structured Deep Breathing Exercises Education in Patient with Coronary Artery Bypass Graft

2021 ◽  
Vol 6 (18) ◽  
Author(s):  
Noraini Hashim ◽  
Norhaini Majid ◽  
Norizan Masri ◽  
Suryanto Suryanto
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Deep Breathing ◽  
Artery Bypass Graft ◽  
Breathing Exercises ◽  
Arterial Blood

Pre-operative evaluation and preparation of the patient for cardiac surgery affect post-operative outcomes and progress. A standardized pre-operative education will ensure that adequate and correct information is delivered to the patients. The research aims to determine the effectiveness of structured deep breathing exercises education on oxygenation in patients with coronary artery bypass graft (CABG) surgery. The study used a quasi-experimental design. A total of 81 patients were recruited for this study. The SpO2 and PaO2 levels were measured using capillary saturation and Arterial Blood Gases (ABG). The results showed significant differences in SpO2 scores between control and intervention groups post-intervention. Keywords: Pre-operative education; Cardiac surgery; deep breathing exercises eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i18.3075

scholarly journals Blood Glucose Profile Post Coronary Artery Bypass Graft in Rsup H. Adam Malik Medan

2018 ◽  
Vol 5 (1) ◽  
pp. 3470-3472
Author(s):  
Farhan Syarif ◽  
Marshal . ◽  
Doddy Prabisma Pohan
Keyword(s):  
Blood Glucose ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Glucose Level ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Significant Difference

Cardiopulmonary bypass (CPB) is widely used for systemic and oxygenated systemic settings during open heart surgery. (Simon L, 2004) To date there is yet to be found a definitive biochemical marker that can be considered prognostic in patients who subside. using a CPB machine. Hyperglycemia is defined as a glucose level above the normal physiological range. Normal blood glucose level is 70-120 mg and levels > 120 mg/dL is a diagnostic level for diabetes. During CPB and coronary artery bypass off-pump (OPCAB), most patients tend to have elevated blood glucose levels despite no previous diabetes medical history. This study uses a descriptive study design study with a retrospective approach. The study was conducted in the Division of Cardiac and Cardiac Surgery of the Department of Surgery of the Faculty of Medicine USU/ RSUP H. Adam Malik Medan. The study was conducted after the proposal was approved. The population in this study were patients who performed Coronary Artery ByPass Graft surgery using Cardiopulmonary Bypass (CBP) at RSUP H. Adam Malik Medan in 2016 (01 January - 31 December 2016). The study involved patients who performed Coronary Artery ByPass Graft surgery using a CPB machine in RS. Haji Adam Malik Medan. The number of research subjects was 41 people. . Based on sex it is seen that more men (84.3%) than women. The mean of postoperative KGD H + 3 was the highest KGD that was 218,28 + 23,5 mg / dL. The use of Humulin R is most commonly used in insulin therapy with patients with postoperative CPB hyperglycemia. Based on the ANOVA test there was a significant difference in the value of KGD in H + 1 post CPB operation compared to H + 2 post CPB operation (p = 0.013, p <0.05).

Comparison of the effect of incentive spirometry and deep breathing exercises on hemodynamic parameters of patients undergoing coronary artery bypass graft surgery: A Clinical Trial

2021 ◽  
Author(s):  
Maasoumeh Barkhordari-Sharifabad ◽  
Fatemeh Zerang
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Deep Breathing ◽  
Artery Bypass Graft ◽  
Breathing Exercises ◽  
The Mean ◽  
Incentive Spirometry

Abstract Background Hemodynamic changes are among the common complications after coronary artery bypass graft (CABG) surgery. Incentive spirometry and deep breathing exercises are widely used in patients undergoing coronary artery bypass graft surgery. The aim of the present study was to compare the effect of incentive spirometry and deep breathing exercises on hemodynamic parameters of patients undergoing coronary artery bypass graft surgery. Methods This is a clinical trial that was performed on 40 heart patients who were candidates for coronary artery bypass graft surgery. Participants were selected using convenience sampling and then randomly divided into two groups. One day before surgery, one group was taught how to perform deep breathing exercises (DBE) and the other group was taught how to use incentive spirometry in practice. Hemodynamic indices were measured and recorded before the intervention, the first, second, and the third day after the intervention. Data analysis was carried out using SPSS ver.16 and descriptive and inferential statistical tests. Findings: The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the first day after the intervention in patients undergoing the incentive spirometry group was significantly higher than the DBE group (p < 0.05). On the third day after the intervention, the mean arterial SaO2 in patients of the incentive spirometry group was significantly higher than the DBE group and the mean respiratory rate (RR) in patients in the incentive spirometry group was significantly lower than the DBE group (p < 0.05). However, there was no significant difference between the two groups in terms of other indices (p > 0.05). Conclusion The results showed that incentive spirometry has a greater effect on hemodynamic indices of patients undergoing CABG compared to DBE, so, it is recommended to use incentive spirometry to improve hemodynamic indices in these patients. Trial registration: Iranian Registry of Clinical Trials (IRCT), IRCT20191028045267N1. Registered 12 March 2020, https://www.irct.ir/trial/43365

A Comparative Study of the efficacy of preoperative of oral Pregabalin and placebo on acute Postoperative Pain After Coronary Artery Bypass Graft Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Ahmed Ibrahim Ahmed ◽  
Hatem Said Abdel Hamed ◽  
Nevein Gerges Fahmy ◽  
Wael Abdel Aziz Mohamed
Keyword(s):  
Coronary Artery ◽  
Postoperative Pain ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Pain Control ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Acute Postoperative Pain ◽  
Significant Difference

Abstract Background Pain that pursues coronary artery bypass graft (CABG) surgery is usually associated with increased both recovery duration and hospital stay. Patient outcome could be worsened owing to large doses of opioids for pain control through over sedation, and prolonged mechanical ventilation. This study was designed to evaluate the effect of preemptive pregabalin on post CABG surgery pain control. Objective To study the effect of pregabalin administration before surgery in the treatment of acute postoperative pain after coronary artery bypass surgery. To study the effect of pregabalin on the consumption of opioids for acute postoperative pain. Patients and Methods Type of Study: Prospective double – blinded, randomized controlled Trial. After Approval is obtained from the research ethics committee of anesthesia and intensive care department, Ain Shams University. Study Setting: National Heart Institute, Egypt. Study Period: 6 months. Study Population: adult undergoing coronary artery bypass graft surgeries. Results Analysis of VAS in the first 24 hours after extubation showed significant difference between Groups 1 and 2. Analysis of systolic blood pressure and heart rate in the first 24 hours showed no significant difference between Groups 1 and 2. It is important to note that because the observed “average” differences in systolic blood pressure and heart rate between groups were small, the clinical significance of such differences can be questioned. Furthermore, it would not be realistic to expect a big, dramatic benefit from a single intervention in a complex, multifactorial care process, such as in cardiac surgery. Given the complexity of these cases, we believe that even a small reduction in pain intensity is a meaningful improvement as we all try to improve care for these patients. Conclusion Pregabalin can be effective for reduction of post CABG pain and have better patient satisfaction if given preemptively with single dose preoperatively.

scholarly journals Female Gender Is an Independent Predictor of Operative Mortality After Coronary Artery Bypass Graft Surgery

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Ron Blankstein ◽  
R. Parker Ward ◽  
Morton Arnsdorf ◽  
Barbara Jones ◽  
You-Bei Lou ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Operative Mortality ◽  
Independent Predictor ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Female Gender ◽  
Artery Bypass Graft ◽  
Significant Difference

Background— Women have a higher operative mortality (OM) after coronary artery bypass graft (CABG) surgery than men. Suggested contributing factors have included women’s increased age, advanced disease, comorbidities, and smaller body surface area (BSA). It is unclear whether women’s increased risk factors fully account for this difference or whether female gender within itself is associated with increased OM. We attempted to determine whether, all other factors being equal, there is a significant difference in OM between men and women undergoing CABG. Methods and Results— We retrospectively reviewed a clinical database of 15,440 patients who underwent CABG at 31 Midwestern hospitals in 1999–2000. Each patient record consisted of >400 data elements. Risk-adjusted mortality rates were computed using a predictive equation derived by stepwise logistic regression. Overall, women were older, had a higher incidence of diabetes and valvular disease, and were more likely to be presenting in shock. The OM for the entire population was 2.88% (women 4.24% versus men 2.23%, P <0.0001). Lower BSA was found to be an independent predictor of increased mortality, and a direct inverse relationship between BSA and OM was noted. After adjusting for all comorbidities including BSA, female gender remained an independent predictor of increased mortality (risk-adjusted OM was 3.81% for women and 2.43% for men). Thus, whereas risk adjustment reduced women’s OM from 90% higher than men’s to 22% higher, a significant difference remained. Conclusions— In this contemporary data set from 31 Midwestern hospitals, female gender was an independent predictor of perioperative mortality, even after accounting for all comorbidities, including low BSA.

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