Abstract
Background: This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation. Methods: 78 patients undergoing coronary artery bypass graft (CABG) or/and valvular heart disease surgeries were randomly assigned into an early and enhanced physiotherapy care group (EEPC group; n = 39) and a conventional physiotherapy care group (CPC group; n = 39). Treatment protocol for the EEPC group included ≤3 Mets of physical activity and respiratory physiotherapy on zero post-operative day and an extra physiotherapy session during the first three post-operative days, whereas the CPC group was treated with usual physiotherapy care after the first post-operative day. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were also performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy. Results: Participants’ mean age was 51.9 ± 13.8 years. Of them 48 (61.5%) underwent CABG. Baseline and peri-procedural characteristics did not differ between the two groups. The total duration of hospital and ICU stay were significantly higher in the CPC group compared to the EEPC group (8.1 ± 0.4 days versus 8.9 ± 0.6 days and 25.4 ± 3 h versus 23.2 ± 0.6 h, p < 0.001, respectively). Statistically significant differences in pre-intervention oxygen saturation, and post-intervention PO2 and lactate levels were also observed between the two groups (p = 0.022, 0.027 and 0.001, respectively). Conclusion: In on-pump cardiac surgery, early and enhanced post-procedural physical activity (≤3 METS) can prevent a prolonged ICU stay and decrease the duration of hospitalization while ameliorating post-operative hemodynamic and oxymetric parameters.
Highlights
Millions of patients benefit annually from open heart surgery, while the actual number of such operations in western countries remains stable over the last decade, despite the current advancements in cardiovascular medicine, offering pharmacological or minimally invasive alternatives [1,2]
We aimed to inquire into the potential impact of early mobilization and physical activity combined with extra sessions of active postoperative physiotherapy, on the duration of intensive care unit (ICU) stay and hospitalization, as well as on clinical and laboratory parameters following open heart surgery
A double-blinded randomized clinical trial was designed to investigate the effect of respiratory physiotherapy and early mobilization and exercise on patients undergoing cardiac surgery [coronary artery bypass grafting (CABG) or valvular surgery] under extracorporeal circulation
Summary
Millions of patients benefit annually from open heart surgery, while the actual number of such operations in western countries remains stable over the last decade, despite the current advancements in cardiovascular medicine, offering pharmacological or minimally invasive alternatives [1,2]. None of them investigated the influence of intensified/intensive post-operative physiotherapy and rapid mobilization This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy. Conclusion: In onpump cardiac surgery, early and enhanced post-procedural physical activity (≤3 METS) can prevent a prolonged ICU stay and decrease the duration of hospitalization while ameliorating post-operative hemodynamic and oxymetric parameters
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