Westerdahl E.1,2, Jonsson M.1,2, Emtner M.3
1Örebro University Hospital, Örebro, Sweden, 2Örebro University, Örebro, Sweden, 3Uppsala University, Uppsala, Sweden
Background: Cardiac surgery patients often develop a restrictive pulmonary impairment and gas exchange abnormalities in the early postoperative period. Chest physiotherapy is routinely prescribed in order to reduce or prevent these complications. Besides early mobilization, positioning and shoulder girdle exercises, various breathing exercises have been implemented as a major component of postoperative care. Impairments in pulmonary function have been described several months after surgery. Evaluation of pulmonary function in a longer perspective is lacking. In this prospective study pulmonary function and subjective breathing and coughing ability were investigated one year after cardiac surgery.
Purpose: In this prospective study pulmonary function and subjective breathing and coughing ability were investigated one year after cardiac surgery.
Methods: Pulmonary function measurements, peripheral oxygen saturation, dyspnoea, subjective breathing and coughing ability and pain were evaluated before and 1 year after surgery in 150 patients undergoing cardiac surgery via sternotomy.
Results: Before surgery the patients had normal lung function in relation to reference values. One year after cardiac surgery spirometry measurements (vital capacity, forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow and functional residual capacity) were significantly decreased (by 4-5%) compared to preoperative values (p 0.05). The patients had no dyspnoea. Saturation of peripheral oxygen was unchanged compared to baseline values. Sternotomy-related pain was low 1 year postoperatively at rest (median 0 [0-7]), while taking a deep breath (0 [0-4]) and while coughing (0 [0-8]). One year after surgery a weak negative correlation was found between pulmonary function (spirometry percentage predicted) and dyspnoea, breathing and coughing ability.
Conclusion(s): One year after cardiac surgery spirometry was still significantly slightly (4-5%) decreased. Measured levels of pain were low and saturation of peripheral oxygen was same as preoperatively.
Implications: A variety of postoperative regimens are recommended to the spontaneously breathing patient to improve lung function in the postoperative period. Different breathing exercises are recommended in different parts of the world, and there is still a need to find the most effective treatment technique to recover pulmonary function after cardiac surgery.
Funding acknowledgements: Swedish Heart Lung Foundation, Swedish Heart and Lung Patients National Association, Swedish Research Council, Örebro County Council, Uppsala University, Sweden.
Topic: Cardiorespiratory
Ethics approval: The Regional Ethical Review Board in Uppsala, Sweden (2007/160).
All authors, affiliations and abstracts have been published as submitted.
