&lt;![CDATA[&lt;B&gt;Evaluation of pulmonary function in patients following on and off-pump coronary artery bypass grafting&lt;/B&gt;]]&gt;

Guizilini, Solange; Gomes, Walter J.; Faresin, Sônia Maria; Bolzan, Douglas W.; Alves, Flávia dos S; Catani, Roberto; Buffolo, Ênio

doi:10.1590/s1678-97412005000300013

Cited by 17 publications

(22 citation statements)

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“…[19][20][21][22][23][24] Similar results were found in our study. Conventionally, coronary artery bypass grafting involves trauma to the rib cage, which causes pain that can be intensified by coughing.…”

Section: Discussionsupporting

confidence: 89%

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Gomes

et al. 2014

Respir Care

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BACKGROUND: Previous investigation showed that the volume-time curve technique could be an alternative for endotracheal tube (ETT) cuff management. However, the clinical impact of the volume-time curve application has not been documented. The purpose of this study was to compare the occurrence and intensity of a sore throat, cough, thoracic pain, and pulmonary function between these 2 techniques for ETT cuff management: volume-time curve technique versus minimal occlusive volume (MOV) technique after coronary artery bypass grafting. METHODS: A total of 450 subjects were randomized into 2 groups for cuff management after intubation: MOV group (n ‫؍‬ 222) and volume-time curve group (n ‫؍‬ 228). We measured cuff pressure before extubation. We performed spirometry 24 h before and after surgery. We graded sore throat and cough according to a 4-point scale at 1, 24, 72, and 120 h after extubation and assessed thoracic pain at 24 h after extubation and quantified the level of pain by a 10-point scale. RESULTS: The volume-time curve group presented significantly lower cuff pressure (30.9 ؎ 2.8 vs 37.7 ؎ 3.4 cm H 2 O), less incidence and intensity of sore throat (1 h, 23.7 vs 51.4%; and 24 h, 18.9 vs 40.5%, P < .001), cough (1 h, 19.3 vs 48.6%; and 24 h, 18.4 vs 42.3%, P < .001), thoracic pain (5.2 ؎ 1.8 vs 7.1 ؎ 1.7), better preservation of FVC (49.5 ؎ 9.9 vs 41.8 ؎ 12.9%, P ‫؍‬ .005), and FEV 1 (46.6 ؎ 1.8 vs 38.6 ؎ 1.4%, P ‫؍‬ .005) compared with the MOV group. CONCLUSIONS: The subjects who received the volumetime curve technique for ETT cuff management presented a significantly lower incidence and severity of sore throat and cough, less thoracic pain, and minimally impaired pulmonary function than those subjects who received the MOV technique during the first 24 h after coronary artery bypass grafting.

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Section: Discussionsupporting

confidence: 89%

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Gomes

et al. 2014

Respir Care

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“…After surgery, there is a 40% to 60% drop in volumes and capacities in relation to preoperative values [8,9]. Several factors are responsible for this postoperative pulmonary dysfunction.…”

Section: Data Expressed As Mean ± Standard Deviation P Values For Comentioning

confidence: 99%

“…The emergence of OPCAB techniques have minimized intraoperative and postoperative complications, resulting in shorter hospitalization. Guizilini et al [8] demonstrated that patients underwent off-pump surgery had better preservation of pulmonary function when compared to those on-pump. Recently, Silva et al [12] demonstrated that significant deterioration in lung function occurs following either on-and off-pump CABG.…”

Section: Data Expressed As Mean ± Standard Deviation P Values For Comentioning

confidence: 99%

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Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea

Cancio¹,

Guizilini²,

Bolzan³

et al. 2012

Rev Bras Cir Cardiovasc

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Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea: estudo controlado randomizado Subxyphoid pleural drain confers lesser impairment in respiratory muscle strength, oxygenation and lower chest pain after off-pump coronary artery bypass grafting: a randomized controlled trial Abstract Objective: To evaluate respiratory muscle strength, oxygenation and chest pain in patients undergoing off-pump coronary artery bypass (OPCAB) using internal thoracic artery grafts comparing pleural drain insertion site at the subxyphoid region versus the lateral region.Methods: Forty patients were randomized into two groups in accordance with the pleural drain site. Group II (n = 19) -pleural drain exteriorized in the intercostal space; group (SI) (n = 21) chest tube exteriorized at the subxyphoid region. All patients underwent assessment of respiratory muscle strength (inspiratory and expiratory) on the pre, 1, 3 and 5 postoperative days (POD). Arterial blood gas analysis was collected on the pre and POD1. The chest pain sensation was measured 1, 3 and 5 POD.Results: A significant decrease in respiratory muscle strength (inspiratory and expiratory) was seen in both groups until POD5 (P <0.05). When compared, the difference between groups remained significant with greater decrease in the II (P <0.05). The blood arterial oxygenation fell in both groups (P <0.05), but the oxygenation was lower in the II (P <0.05). Referred chest pain was higher 1, 3 and 5 POD in the II group (P <0.05). The orotracheal intubation time and postoperative length of hospital stay were higher in the II group (P <0.05).Conclusion: Patients submitted to subxyphoid pleural drainage showed less decrease in respiratory muscle strength, better preservation of blood oxygenation and reduced thoracic pain compared to patients with intercostal drain on early OPCAB postoperative. 104Cancio ASA, et al. -Subxyphoid pleural drain confers lesser impairment in respiratory muscle strength, oxygenation and lower chest pain after off-pump coronary artery bypass grafting: a randomized controlled trial Bras Cir Cardiovasc 2012;27(1):103-9 Rev

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“…Já no pós-operatório merecem destaque, além da diminuição da estabilidade e complacência da parede torácica pela esternotomia mediana, 11,15 os longos períodos em decú-bito dorsal, à presença de dor 11 e drenos implicando, diretamente, na manutenção de baixos volumes pulmonares. 4,6,12,16,20,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Devido ao quadro de disfunção pulmonar associado à CC e suas possíveis repercussões, a fisioterapia respiratória (FiR) tem sido muito utilizada com o intuito de reverter ou amenizar tal quadro, evitando o desenvolvimento de complicações pulmonares, pela utilização de grande variedade de técnicas. 4,6,8,9,16,21,22,29,32,[43][44][45][46] Sua atuação inicia-se com o "desmame" ventilatório e estende-se até a manutenção do paciente em ventilação espontânea após extubação.…”

Section: Palavrasunclassified

Comparação do uso da pressão positiva com a fisioterapia convencional e incentivadores respiratórios após cirurgia cardíaca: revisão de literatura

Silveira

Sípoli

Augusto

et al. 2011

Medicina (Ribeirão Preto)

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Introduction: Postoperative pulmonary complications in patients undergoing cardiac surgeries are usually a clinical challenge, which can be prevented and treated with specific physical therapy techniques. However, it is not known which technique is the most effective. Objective: Literature review with the objective of assessing the effectiveness of positive pressure (CPAP, IPPB, NIV-2P) compared to standard physioterapy therapy and incentive spirometry on improving pulmonary function in postoperative cardiac surgery patients. Methods: English and Portuguese studies were used as references, searching for specific descriptors on the following data sources: BIREME, SciELO Brazil, LILACS, PUBMED, from 1985 to 2010. Only randomized clinical trials were included. Results: Ten randomized control trials were included in this review. About the most effective technique, two studies showed that CPAP and NIV-2P were more effective than standard physioterapy and incentive spirometry. In other two studies, NIV-2P were more effective than nasal oxygen catheter and standard physioterapy. Conclusion: There is no evidence in the literature about the most effective physiotherapy technique. Also, it is not known if the association of positive pressure, standard physioterapy and incentive spirometry can be more effective. It is important to emphasize that no selected study compared the three modalities of positive pressure.

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<![CDATA[<B>Evaluation of pulmonary function in patients following on and off-pump coronary artery bypass grafting</B>]]>

Abstract: Avaliação da função pulmonar em pacientes submetidos à cirurgia de revascularização do miocárdio com e sem circulação extracorpórea

Cited by 17 publications

References 0 publications

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Clinical Use of the Volume-Time Curve for Endotracheal Tube Cuff Management

Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea

Comparação do uso da pressão positiva com a fisioterapia convencional e incentivadores respiratórios após cirurgia cardíaca: revisão de literatura

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