The aim of the study was to evaluate the effects of preoperative respiratory rehabilitation on functional capacity, length of stay in intensive care unit (ICU), duration of mechanical ventilation (MV) and total hospitalization, as well as to estimate arterial blood gas (ABG) values in patients undergoing cardiac surgery. Nineteen patients were included in the randomized observational study, divided into two groups: group A (intervention) and B (control). Preoperative and postoperative rehabilitation was performed in group A, and only postoperative rehabilitation in group B. Rehabilitation was carried out according to a predefined protocol. We used ABG to evaluate respiratory function, two-minute walk test (2MWT) and sit-to-stand test to assess functional capacity. The following data were obtained from medical documentation: duration of MV, length of stay at ICU, occurrence of postoperative pulmonary complications, and length of total hospitalization in both groups. Significant between-group difference was found for the length of total hospitalization and duration of MV (p<0.05 both). Analysis of the mean values of 2MWT on the last day of hospitalization (p=0.005), sit-to-stand test before surgery (p=0.022) and on the last day of hospitalization (p=0.008) showed statistically significant differences. The length of hospital stay significantly correlated with preoperative rehabilitation in group A (r=0.885; p<0.0001). There was no difference in ABG parameters between the groups. The study showed that preoperative respiratory rehabilitation had an effect on reducing duration of MV and length of total hospitalization, and improved functional capacity.

Introduction: Cardiovascular diseases (CVD) are leading factor in global mortality and morbidity. It is the cause of 1/3 of total annual mortality, while coronary heart disease (CHD), as one of the CVD entities, is responsible for 85% of deaths worldwide. The aim of the study is to show the importance of the first phase of cardiac rehabilitation (CR) in patients who are going on cardiac surgery, as well as the impact on respiratory function, the occurrence of pulmonary complications and the length of hospitalization. Methods: A sample of 18 patients was included in the randomized observer study. First phase of CR was carried out according to a predefined protocol. We used arterial blood gases (ABG) to evaluate the respiratory function, "two-minute walk test" (2MWT) to assess the functional capacity Data taken from medical documentation are the duration of mechanical ventilation (MV), the length of stay in the ICU, occurrence of the postoperative pulmonary complications and duration of total hospitalization. Results: The test sample consisted of 12 men (60.58 ± 8.33) and 6 women (66.00 ± 6.51). The mean value of CR was 6.15 ± 3.98 days and MV 19,67±11,23 hours. There were no pulmonary complications in 61,11% patients. Using ABG, a statistically significant difference was found in PO2 after extubating and at the last day in ICU (p = 0.01). 2MWT preoperatively significantly correlated with the examined on the last day of hospitalization (r = 0.648 p-value <0.001) well as the length of postoperative hospitalization and duration of mechanical ventilation (r = 0.708 p-value <0.001). Conclusion: The study showed that first phase of cardiac rehabilitation may positively affect the improvement of functional capacity.

Sažetak. Istraživanja asimetrije i funkcionalnih razlika pojedinih oblasti moždane kore, često otvaraju nova pitanja, posebno kada je reč o zadnjem delu temenog režnja, koji ima izuzetno složenu funkciju. Lobulus parietalis superior (LPS) i precuneus (P) su delovi iste zadnje parijetalne kortikalne oblasti (5 i 7). Utvrđivane su razlike u debljini kore LPS na spoljašnjoj i P na unutrašnjoj strani hemisfere, kao i razlike između leve i desne strane. Merena je dužina hemisfera 20 mozgova odraslih osoba oba pola. Rezovi levog i desnog LPS i P obojeni su po Nisslu. Posebno su analizirani slučajevi sa većom levom, odnosno većom desnom hemisferom. Kod većih levih hemisfera (15 mozgova) kora levog LPS (3,76 mm) bila je značajno (p<0,001) deblja u odnosu na levi P (3,13 mm), bez drugih značajnih razlika. Kod većih desnih hemisfera (5 mozgova) nije bilo značajne razlike u debljini kore P desno (3,34 mm) i levo (3,13 mm), kao ni levog (3,76 mm) i desnog LPS (3,67 mm). Međutim, u tim slučajevima kora desnog LPS (3,66 mm) bila je značajno deblja (p<0,05) od kore desnog P (3,33 mm), a kora levog LPS (3,67 mm) bila je značajno (p<0,05) deblja od kore levog P (3,35 mm). Kod većih desnih hemisfera zadnji parijetalni korteks je obostrano deblji na spoljašnjoj strani hemisfere, dok kod većih levih hemisfera to važi samo za levu hemisferu. U obe grupe značajno je deblja kora LPS od P.Ključne riječi: Kora mozga, Parijetalni režanj opened new issues, particularly in terms of the posterior parietal lobe, which has a very complex function. Lobulus parietalis superior (LPS) and precuneus (P) are parts of the same rear parietal cortical area (5 and 7). There were established the differences in the thickness of the LPS cortex on the outer and P on the inner side of the hemisphere, as well as the differences between the left and the right side. It was measured the hemisphere length of 20 brains of both male and female adults. Section of the left and right LPS and P were colored according to Nissl. The cases with larger left and right hemisphere, respectively, were particularly analyzed. In larger left hemispheres (15 brains), cortex of the left LPS (3.76 mm) was significantly (p<0.001) thicker relative to the left P (3.13 mm), without other significant differences. In larger right hemispheres (5 brains), there was no significant difference in the cortex thickness of the P on the right (3,34 mm) and left (3.13), nor in the left (3.76) and right (3.67 mm) LPS. However, in such cases, the right LPS cortex (3.66 mm) was significantly thicker(p<0,05) than the right P cortex (3.33 mm), and the left LPS cortex (3.67 mm) was significantly thicker(p<0.05) than the left P cortex (3.35 mm). In larger right hemispheres, the rear parietal cortex was thicker on both sides of the outer hemisphere, while in larger left hemispheres it was the case only on the left hemisphere. In both groups, the LPS cortex was significantly thicker than the P cortex.