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Cardiac Prehabilitation

Michael McCann1, Nikki Stamp1, Ann Ngui1

  • 1Fiona Stanley Hospital, Perth, WA, Australia.

Journal of Cardiothoracic and Vascular Anesthesia
|February 16, 2019
PubMed

Insights

Cardiac prehabilitation proactively addresses modifiable risks before surgery. Comprehensive preoperative programs may improve outcomes for complex cardiac surgery patients.

Area of Science:

  • Cardiology
  • Perioperative Medicine
  • Geriatrics

Background:

  • Cardiac surgery patient care is increasingly complex due to comorbidities, frailty, and psychosocial factors.
  • Many risks for poor postoperative outcomes are modifiable if addressed before surgery.
  • Cardiac prehabilitation proactively applies strategies from cardiac rehabilitation.

Purpose of the Study:

  • To evaluate interventions targeting modifiable perioperative risk factors in cardiac surgery.
  • To identify optimal preoperative programs for improving outcomes after cardiac surgery.
  • To address the need for comprehensive prehabilitation strategies.

Main Methods:

  • Review of evidence on prehabilitation domains: aerobic conditioning, respiratory muscle training, lifestyle modification, diabetic control, sleep, and psychoeducation.
  • Focus on interventions implemented proactively before cardiac surgery.
  • Exploration of strategies to mitigate perioperative risk factors.

Main Results:

  • Evidence supports prehabilitation interventions in multiple domains potentially improving outcomes.
  • Selected preoperative interventions show promise for enhancing patient recovery.
  • The optimal composition of a preoperative program remains undetermined.

Conclusions:

  • Prehabilitation offers a proactive approach to managing complex cardiac surgery patients.
  • Targeting modifiable risk factors preoperatively may reduce adverse outcomes.
  • Further research is needed to define optimal comprehensive preoperative programs.

Keywords:
cardiac surgeryfast trackprehabilitationrespiratory muscle training

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