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 .
Atelectasis and Gas Exchange after Cardiac Surgery
Background Sometimes a high intrapulmonary shunt occurs after cardiac surgery , and impairment of lung function and oxygenation can persist for 1 week after operation . Animal studies have shown that postoperative shunt can be explained by atelectasis . In this study the authors tried to determine if atelectasis can explain shunt in patients who have had cardiac surgery . Methods Nine patients having coronary artery bypass graft surgery and nine patients having mitral valve surgery were examined using the multiple inert gas elimination technique before and after operation . On the first postoperative day , computed tomography scans were made at three levels of the thorax . Results Before anesthesia , the average shunt was low ( 2 + /‐ 3 % ; range , 0–13 % ) , but on the first postoperative day shunt had increased to 12 + /‐ 6 % ( range , 3–28 % ) . The computed tomography scans showed bilateral dependent densities in all patients but one . The mean area of the densities was 8 + /‐ 8 % ( range , 0–37 % ) of total lung area , corresponding to a calculated fraction of collapsed lung tissue of 20 + /‐ 14 % ( range , 0–59 % ) . In the basal region , the calculated amount of collapsed tissue was 28 + /‐ 19 % ( range , 0–73 % ) . One mitral valve patient was an outlier and had a large shunt both before and after the operation . Conclusions Large atelectasis in the dorsal part of the lungs was found on the first postoperative day after cardiac surgery . However , there was no clear correlation between atelectasis and measured shunt fraction
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 .