Preoperative respiratory muscle dysfunction is a predictor of prolonged invasive mechanical ventilation in cardiorespiratory complications after heart valve surgery

Rodrigues, Alfredo José; Mendes, Viviany; Ferreira, Paulo Eduardo Gomes; Xavier, Marcia Arruda Fajardo; Augusto, Viviane S.; Bassetto, Solange; Évora, Paulo Roberto Barbosa

doi:10.1016/j.ejcts.2010.08.021

Cited by 21 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The mean MIP before surgery was 78 cmH 2 O and mean MEP was 122 cmH 2 O. Both lower and higher preoperative values for MIP (66 and 84 cmH 2 O) has been reported [ 8 , 11 , 12 ]. Results may be dependent on different equipment for the measurement, different performance of the tests, and use of diverse predicted values for respiratory muscle strength.…”

Section: Discussionmentioning

confidence: 99%

“…The impact of preoperatively decreased respiratory muscle strength in patients after cardiac surgery has not been fully investigated. Rodrigues et al [ 8 ] found an association between impaired preoperative MIP and MEP (<70 % of predicted value defined by Neder et al [ 32 ]) and the need for prolonged invasive mechanical ventilation. In abdominal, thoracic and cardiac surgery patients, MIP and/or MEP above 75 % of predictive value has been shown to be protective against the development of postoperative pulmonary complications, defined as a temperature >37.5 °C, bronchitis, atelectasis, and pneumonia during hospitalisation [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative respiratory dysfunction has been shown to prolong postoperative mechanical ventilation after heart valve surgery and impaired respiratory muscle strength has been described as a determinant of decreased functional capacity after coronary artery bypass grafting (CABG) [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Urell

Emtner

Hedenström

et al. 2016

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundPostoperative pulmonary impairments are significant complications after cardiac surgery. Decreased respiratory muscle strength could be one reason for impaired lung function in the postoperative period. The primary aim of this study was to describe respiratory muscle strength before and two months after cardiac surgery. A secondary aim was to describe possible associations between respiratory muscle strength and lung function.MethodsIn this prospective observational study 36 adult cardiac surgery patients (67 ± 10 years) were studied. Respiratory muscle strength and lung function were measured before and two months after surgery.ResultsPre- and postoperative respiratory muscle strength was in accordance with predicted values; MIP was 78 ± 24 cmH2O preoperatively and 73 ± 22 cmH2O at two months follow-up (p = 0.19). MEP was 122 ± 33 cmH2O preoperatively and 115 ± 38 cmH2O at two months follow-up (p = 0.18). Preoperative lung function was in accordance with predicted values, but was significantly decreased postoperatively. At two-months follow-up there was a moderate correlation between MIP and FEV1 (r = 0.43, p = 0.009).ConclusionsRespiratory muscle strength was not impaired, either before or two months after cardiac surgery. The reason for postoperative lung function alteration is not yet known. Interventions aimed at restore an optimal postoperative lung function should focus on other interventions then respiratory muscle strength training.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Urell

Emtner

Hedenström

et al. 2016

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…What is more, authors tend to narrow down the groups of subjects, creating predictive models for prolonged ventilation in patients after one type of procedure only - for example, after coronary revascularisation with cardiopulmonary bypass [14,15], adult valve procedures [16,20],or aortic aneurysm surgery [17]. The only benefit of this approach is the increased homogeneity of the studied group.…”

Section: Discussionmentioning

confidence: 99%

Prolonged ventilation post cardiac surgery - tips and pitfalls of the prediction game

Knapik

Cieśla

Borowik

et al. 2011

J Cardiothorac Surg

View full text Add to dashboard Cite

BackgroundFew available models aim to identify patients at risk of prolonged ventilation after cardiac surgery. We compared prediction models developed in ICU in two adjacent periods of time, when significant changes were observed both in population characteristics and the perioperative management.MethodsWe performed a retrospective review of two cohorts of patients in our department in two subsequent time periods (July 2007 - December 2008, n = 2165; January 2009 - July 2010, n = 2192). The study was approved by the Institutional Ethics Committee and the individual patient consent was not required. Patients were divided with regard to ventilation time of more or less than 48 hours. Preoperative and procedure-related variables for prolonged ventilation were identified and multivariate logistic regression analysis was performed separately for each cohort.ResultsMost recent patients were older, with more co-morbidities, more frequently undergoing off-pump surgery. At the beginning of 2009 we also changed the technique of postoperative ventilation. Percentage of patients with prolonged ventilation decreased from 5.7% to 2.4% (p < 0.0001).Preoperative and procedure-related variables for prolonged ventilation were identified. Prediction models for prolonged ventilation were different for each cohort. Most recent significant predictors were: aortic aneurysm surgery (OR 12.9), emergency surgery (OR 5.3), combined procedures (OR 5.1), valve procedures (OR 3.2), preoperative renal dysfunction (OR 2.9) and preoperative stroke or TIA (OR 2.8).ConclusionsPrediction models for postoperative ventilation should be regularly updated, particularly when major changes are noted in patients' demographics and surgical or anaesthetic technique.

show abstract

“…"beira leito", estas duas formas de avaliação são importantes ferramentas, que podem auxiliar a minimizar as complicações respiratórias no pós-operatório de cirurgias cardíacas e consequentemente diminuindo o tempo de internação hospitalar(RODRIGUES et al, 2011;SULTAN;HAMILTON;ACKLAND, 2012;ZANINI et al, 2016).…”

unclassified

Determinação de valores de referência para a força de preensão palmar e força muscular respiratória em adultos saudáveis

Chagas¹

View full text Add to dashboard Cite

Preoperative respiratory muscle dysfunction is a predictor of prolonged invasive mechanical ventilation in cardiorespiratory complications after heart valve surgery

Abstract: Our results have demonstrated that respiratory muscle dysfunction, among other clinical factors, is associated with the need for PIMV due to cardiovascular or pulmonary dysfunction after heart valve surgery.

Cited by 21 publications

References 20 publications

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Prolonged ventilation post cardiac surgery - tips and pitfalls of the prediction game

Determinação de valores de referência para a força de preensão palmar e força muscular respiratória em adultos saudáveis

Contact Info

Product

Resources

About