Evidence derived from small trials suggests that preoperative physical therapy reduces postoperative pulmonary complications ( atelectasis and pneumonia ) and length of hospital stay in patients undergoing elective cardiac surgery .
There is a lack of evidence that preoperative physical therapy reduces postoperative pneumothorax , prolonged mechanical ventilation or all-cause deaths
BACKGROUND After cardiac surgery , physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications .
OBJECTIVES To determine if preoperative physical therapy with an exercise component can prevent postoperative pulmonary complications in cardiac surgery patients , and to evaluate which type of patient benefits and which type of physical therapy is most effective .
Effects of electrostimulation of the vagus afferent endings in patients with coronary artery disease
Background In rats , low-frequency electroneuro-stimulation ( ENS ) of the ear afferent vagus endings and bramstem structures via transauricular electro-acupuncture increases the parasympathetic tone of the autonomic nervous system . We examined the effects of ENS applied in the preoperative period in patients with coronary artery disease ( CAD ) who underwent coronary artery bypass grafting operations Methods ENS was performed in a group of 10 patients with CAD who were classified as Canadian Cardiovascular Society class IV before operation . A second group of 10 patients with a similar degree of CAD compnsed a control group . The efficacy of the procedure was evaluated on the basis of improvement in the patient 's clinical course before and after operation . The presence of major inducible stress protein ( HSP 70i ) and the ATP content of the myocardium was determined in atrial tissue ( part of the right heart auricle ) from both groups of patients . Tissue from patients with Wolff-Parkinson-White ( WPW ) syndrome served as a control , non-ischemic , cardiac tissue . Results A course of 10 ENS procedures improved the patients ' preoperative clinical course , producing a rapid reduction in their angina . By the end of the course , the patients no longer developed angina either at rest or after a moderate physical load , and their dependence on treatment with vasodilators had decreased considerably . Atnal tissue from patients with CAD who were treated with ENS was similar to that from patients with WPW in leaking HSP 70i and in ATP content . In contrast , tissue from the control group of patients with CAD contained HSP 70i and had an increased content of ATP . The antianginal effect of neurostimulation lasted for at least 2–3 weeks after completion of the procedures . The postoperative recovery of patients treated with ENS was characterized by stable hemodynamics and sinus rhythm . Conclusion We conclude that ENS had a central vagotonic/sympatholytic influence on the heart , leading to the development of three main effects in patients with CAD : relief of anginal symptoms , diminution of some biochemical myocardial signs of the disease , and an increase in the heart 's tolerance of operative reperfusion damage
Evidence derived from small trials suggests that preoperative physical therapy reduces postoperative pulmonary complications ( atelectasis and pneumonia ) and length of hospital stay in patients undergoing elective cardiac surgery .
There is a lack of evidence that preoperative physical therapy reduces postoperative pneumothorax , prolonged mechanical ventilation or all-cause deaths
BACKGROUND After cardiac surgery , physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications .
OBJECTIVES To determine if preoperative physical therapy with an exercise component can prevent postoperative pulmonary complications in cardiac surgery patients , and to evaluate which type of patient benefits and which type of physical therapy is most effective .