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Published on: March 27, 2018
Clinical and functional outcomes associated with pulmonary complications after coronary artery bypass grafting
Altina Vitória Souza1, Raquel da Cunha Carvalho1, Daniela da Cruz Dias1
1Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil.
Insights
Postoperative complications after coronary artery bypass grafting (CABG) significantly impair functional performance and muscle strength. These deficits persist at hospital discharge and six months post-surgery, impacting recovery.
Area of Science:
- Cardiovascular Surgery
- Pulmonary Medicine
- Rehabilitation Medicine
Background:
- Coronary artery bypass grafting (CABG) improves outcomes for coronary artery disease but carries risks.
- Pulmonary and functional complications can arise post-CABG due to ventilation, bypass, and immobility, prolonging hospital stays.
Purpose of the Study:
- To evaluate clinical and functional outcomes in patients experiencing pulmonary complications after CABG surgery.
- To assess the impact of postoperative complications on patient recovery and long-term function.
Main Methods:
- A prospective cohort study involving 90 patients undergoing CABG.
- Patients were categorized into complicated (CG) and non-complicated (NCG) groups based on ICU events.
- Functional assessments included the six-minute walk test (6MWT), muscle strength tests (MRC, MIP), and pulmonary function tests, measured preoperatively and at multiple follow-up points.
Main Results:
- The complicated group (CG) showed a significant decrease in 6MWT distance (13%) and muscle strength (MRC 14%, MIP 16%) compared to the non-complicated group (NCG).
- These functional deficits in the CG were statistically significant (p < 0.01) for 6MWT, MRC, and MIP.
- The NCG experienced only minor decreases in these measures, often not statistically significant.
Conclusions:
- Postoperative pulmonary complications following CABG are associated with reduced functional performance and muscle strength.
- These impairments persist at hospital discharge and extend to six months post-surgery.
- Early identification and management of complications are crucial for improving long-term patient outcomes after CABG.
Introduction:
Coronary artery bypass grafting(CABG) is a surgical treatment for coronary artery disease aiming at improving symptoms and life expectancy. Despite this, there are pulmonary and functional complications that may arise during the postoperative period due to invasive mechanical ventilation(IMV), cardiopulmonary bypass and immobility, leading to longer hospital stays.
Objective:
To evaluate the clinical and functional outcomes related to pulmonary complications in the postoperative period of CABG.
Methods:
Prospective cohort. During the ICU stay the patients were divided into: Non Complicated Group(NCG) who did not present complications and Complicated Group(CG) who presented complication. Functional variables were applied as the six-minute walk test(6MWT), gait speed, sit up and stand up test, Timed Up and Go, peripheral muscle strength, ventilatory, pulmonary function and Functional Independence Measure. These tests were applied preoperatively, at ICU discharge, hospital discharge and six months after surgery.
Results:
The study evaluated 90 patients, 59 in the NCG and 31 CG. In the 6MWT there was a 2%(p = 0.43) decrease in the NCG, while the decrease was 13%(p < 0.01) in the CG. In the MRC the drop was 2%(p = < 0.01) in the CNG, while in the CG the drop was 14%(p = < 0.01). In MIP the NCG had a 6%(p = 0.67) decrease, while the CG had a 16%(p = < 0.01) decrease.
Conclusion:
Patients with postoperative complications of CABG may have reduced functional performance, muscle strength, and pulmonary function at hospital discharge and after six months.
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