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Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery
Albert H O-Yurvati1, Michael S Carnes, Michael B Clearfield
1Department of Surgery, Texas College of Osteopathic Medicine, University of North Texas Health Center, Fort Worth, TX 76107, USA.
Insights
Osteopathic manipulative treatment (OMT) improved cardiac function after coronary artery bypass graft (CABG) surgery. This intervention enhanced circulation and oxygen saturation, benefiting patient recovery.
Area of Science:
- Cardiovascular Surgery
- Integrative Medicine
- Physiology
Background:
- Coronary artery bypass graft (CABG) surgery is a prevalent procedure for coronary artery disease.
- The physiological impact of postoperative osteopathic manipulative treatment (OMT) following CABG has not been previously documented.
Purpose of the Study:
- To investigate the effects of OMT on cardiac hemodynamics in patients post-CABG surgery.
Main Methods:
- A pilot prospective clinical study involving 29 subjects (10 treatment, 19 control).
- OMT was administered to the treatment group within 2 hours post-CABG while anesthetized.
- Primary assessments included thoracic impedance, mixed venous oxygen saturation (SvO2), and cardiac index, comparing pre- and post-OMT measurements.
Main Results:
- OMT led to increased thoracic impedance, indicating reduced central blood volume and improved peripheral circulation.
- Significant increases in mixed venous oxygen saturation (SvO2) and cardiac index were observed post-OMT.
- Statistically significant differences in SvO2 and cardiac index were noted between OMT and control groups.
Conclusions:
- OMT demonstrated immediate, beneficial hemodynamic effects following CABG surgery.
- The study suggests OMT positively influences cardiac function and perfusion, aiding patient recovery.
- OMT is a potentially valuable adjunctive therapy for post-CABG patients when administered under sedation and paralysis.
Context:
Coronary artery bypass graft (CABG) surgery is a common procedure for patients with coronary artery disease. The physiologic effects of postoperative osteopathic manipulative treatment (OMT) following CABG have not been documented previously.
Objective:
To determine the effects of OMT on cardiac hemodynamics post-CABG surgery.
Design:
Pilot prospective clinical study (N=29).
Setting And Patients:
Treatment subjects (n=10) undergoing CABG surgery were recruited for postoperative OMT. The primary assessment compared, pre-OMT versus post-OMT, measurements of thoracic impedance, mixed venous oxygen saturation (SvO2), and cardiac index. Records of control subjects (n=19) who underwent CABG surgery--but who did not receive OMT--were assessed for SvO2 and cardiac index at 1 hour and 2 hours postsurgery.
Intervention:
Immediately following CABG surgery (< or = 2 h), OMT was provided to subjects to alleviate anatomic dysfunction of the rib cage caused by median sternotomy and to improve respiratory function. This adjunctive treatment occurred while subjects were completely anesthetized.
Results:
A post-OMT increase in thoracic impedance (P < or = .02) in OMT subjects demonstrated that central blood volume was reduced after OMT, suggesting an improved peripheral circulation. Mixed venous oxygen saturation also increased (P < or = .005) after OMT. These increases were accompanied by an improvement in cardiac index (P < or = .01). Comparisons of postoperative measurements in OMT subjects versus those in control subjects revealed statistically significant differences for SvO2 (P < or = .005) and cardiac index (P < or = .02) between the two groups.
Conclusion:
The observed changes in cardiac function and perfusion indicated that OMT had a beneficial effect on the recovery of patients after CABG surgery. The authors conclude that OMT has immediate, beneficial hemodynamic effects after CABG surgery when administered while the patient is sedated and pharmacologically paralyzed.
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