Preoperative physical therapy for elective cardiac surgery patients

Hulzebos, Erik H.J.; Smit, Yolba; Helders, Paul Pjm; Meeteren, Nico L. van

doi:10.1002/14651858.cd010118

Cited by 86 publications

(86 citation statements)

References 40 publications

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“…Reductions in inspiratory and expiratory muscle strength have been demonstrated up to 12 weeks after surgery. Preoperative interventions to strengthen the inspiratory muscles improve postoperative recovery and reduce the incidence of postoperative pulmonary complications. Therefore, preoperative identification of patients at high risk of developing postoperative pulmonary complications can help clinicians to identify patients who may need additional preventive care (for instance IMT) or monitoring.…”

Section: Respiratory Systemmentioning

confidence: 99%

Making the elderly fit for surgery

Hulzebos

Meeteren

2016

Journal of British Surgery

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Section: Respiratory Systemmentioning

confidence: 99%

Making the elderly fit for surgery

Hulzebos

Meeteren

2016

Journal of British Surgery

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“…Using frailty to guide prehabilitation interventions, such as exercise and nutrition, before an operation may improve a frail patient's physiologic reserve and outcomes after surgery. For example, it has been demonstrated that enrolling patients in preoperative physical therapy programs improves pulmonary complications and shortens hospital lengths of stay after elective cardiac surgery . Prehabilitation studies in patients undergoing surgery for malignancy, however, have been less promising.…”

Section: Frailty and Oncology Surgerymentioning

confidence: 99%

Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Ethun

Bilen

Jani

et al. 2017

CA A Cancer J Clinicians

456

324

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https://www.wileyhealthlearning.com/acs.aspx The concept of frailty has become increasingly recognized as one of the most important issues in health care and health outcomes and is of particular importance in patients with cancer who are receiving treatment with surgery, chemotherapy, and radiotherapy. Because both cancer itself, as well as the therapies offered, can be significant additional stressors that challenge a patient's physiologic reserve, the incidence of frailty in older patients with cancer is especially high—it is estimated that over one‐half of older patients with cancer have frailty or prefrailty. Defining frailty can be challenging, however. Put simply, frailty is a state of extreme vulnerability to stressors that leads to adverse health outcomes. In reality, frailty is a complex, multidimensional, and cyclical state of diminished physiologic reserve that results in decreased resiliency and adaptive capacity and increased vulnerability to stressors. In addition, over 70 different measures of frailty have been proposed. Still, it has been demonstrated that frail patients are at increased risk of postoperative complications, chemotherapy intolerance, disease progression, and death. Although international standardization of frailty cutoff points are needed, continued efforts by oncology physicians and surgeons to identify frailty and promote multidisciplinary decision making will help to develop more individualized management strategies and optimize care for patients with cancer. CA Cancer J Clin 2017;67:362–377. © 2017 American Cancer Society.

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“…A systematic review on the effect of preoperative physiotherapy published in 2012 by the Cochrane collaboration analyzed the data of eight randomized controlled trials, including a total of 856 patients for quantitative analysis (74). While in the abovementioned study preoperative physical therapy was shown to significantly reduce postoperative atelectasis (4 trials, RR 0.52; 95% CI: 0.32-0.87; P=0.01), incidence of pneumonia (5 trials, RR 0.45; 0.95% CI: 0.24-0.83; P=0.01), and inhospital stay (3 trials, −3.2 days; 95% CI: −5.73 to 0.69; P=0.01), other authors failed to show any beneficial effects (75).…”

Section: Patient Optimizationmentioning

confidence: 99%

Acute respiratory distress syndrome after cardiac surgery

2016

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Acute respiratory distress syndrome (ARDS) is a leading cause of postoperative respiratory failure, with a mortality rate approaching 40% in the general population and 80% in the subset of patients undergoing cardiac surgery. The increased risk of ARDS in these patients has traditionally been associated with the use of cardiopulmonary bypass (CPB), the need for blood product transfusions, large volume shifts, mechanical ventilation and direct surgical insult. Indeed, the impact of ARDS in the cardiac population is substantial, affecting not only survival but also in-hospital length of stay and long-term physical and psychological morbidity. No patient undergoing cardiac surgery can be considered ARDS risk-free. Early identification of those at higher risk is crucial to warrant the adoption of both surgical and non-surgical specific preventative strategies. The present review focuses on epidemiology, risk assessment, pathophysiology, prevention and management of ARDS in the specific setting of patients undergoing cardiac surgery.

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Preoperative physical therapy for elective cardiac surgery patients

Cited by 86 publications

References 40 publications

Making the elderly fit for surgery

Making the elderly fit for surgery

Frailty and cancer: Implications for oncology surgery, medical oncology, and radiation oncology

Acute respiratory distress syndrome after cardiac surgery

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