Background: Few studies have evaluated preoperative respiratory muscle strength as a risk factor for postoperative morbidity and mortality. The objective of this study was to evaluate the association of preoperative inspiratory muscle weakness (IMW) and preoperative expiratory muscle weakness (EMW) with duration of mechanical ventilation, length of stay in the intensive care unit (ICU), incidence of postoperative pulmonary complications (PPCs), and mortality in patients undergoing elective cardiac surgery. Materials and methods:This was a prospective observational study. Patients admitted for elective cardiac surgery were recruited. Maximal inspiratory and expiratory pressure were measured before surgery. A multivariate regression model was used to adjust for possible confounding variables and test the association of IMW and EMW with the duration of mechanical ventilation, length of stay in the ICU, PPCs, and hospital mortality.Results: Two hundred and fifty-five patients were included in this study. The presence of IMW was associated with an increase in the duration of mechanical ventilation (P = .012). The presence of EMW was associated with a reduction in the incidence of PPCs (P = .005). IMW had no significant association with length of stay in the ICU, PPCs, or hospital mortality. EMW had no significant association with the duration of mechanical ventilation, length of stay in the ICU, or hospital mortality. Conclusions:In patients undergoing elective cardiac surgery, preoperative IMW is associated with the duration of mechanical ventilation while preoperative EMW is associated with a decrease in PPCs.
Objetivo: Analisar as condições físico-funcionais e a qualidade de vida de pacientes no pré e pós-operatório de cirurgia cardíaca. Materiais e Métodos: Estudo de delineamento transversal, composto por pacientes submetidos à cirúrgica cardíaca eletiva. Os pacientes foram avaliados no pré-operatório e pós-operatório (momento da alta hospitalar) quanto às condições físico-funcionais, incluindo medidas antropométricas, o teste senta e levanta em um minuto (TSL1min), força muscular inspiratória (PImáx) e expiratória (PEmáx), cirtometria torácica e a qualidade vida avaliado pelo WHOQOL-bref. Para análise estatística foi utilizado o software SPSS (versão 23.0) e as variáveis qualitativas foram apresentadas por meio de frequências e porcentagens, e as quantitativas, foram apresentadas por média e desvio-padrão (M±DP). Foi utilizado o teste T de Student para comparação entre o momento pré e pós-operatório, adotando o nível de signifi cância de p≤0,05. Resultados: Na análise entre o pré e pós-operatório observou-se uma redução estatisticamente signifi cativa na avaliação físico-funcional de todas as variáveis analisadas, incluindo o TSL1min (p=0,001), PImáx (p=0,001) e PEmáx (p=0,001) e cirtometria torácica (p=0,001). Porém, os valores da qualidade de vida mostraram uma melhora estatisticamente signifi cativa nos quatro domínios (físico p=0,043; psicológico p=0,001; relações sociais p=0,046 e ambiental p=0,001) e nas duas questões gerais (p=0,001). Conclusões: Houve uma piora da condição física funcional, porém uma melhora da qualidade de vida entre o pré e o pós-operatório de pacientes submetidos à cirurgia cardíaca.
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