The benefit of a preoperative respiratory protocol and
musculoskeletal exercise in patients undergoing cardiac
surgery

Nardi, Paolo; Pisano, Calogera; Altieri, Claudia; Buioni, Dario; Pedicelli, Carlo; Saulle, Silvia; Dandi, Romana; Romano, Alessia; Servadio, Annamaria; Gianlorenzi, Alessandra; Emili, Katia; Ruvolo, Giovanni

doi:10.5114/kitp.2020.97267

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…All studies included in this scoping review were published between November 1987 and September 2022, 4,10,12,18,39–101 33 (49%) of which were published in the past 10 years. Of the included studies, 59 (88%) had an intervention study design, 5 (7%) were observational, 73,74,80,84,99 2 (3%) were qualitative, 12,54 and 1 (2%) was mixed methods 48 . The 67 included studies originated from 21 countries across 5 continents, the majority of which were from Europe (n=28; 42%).…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies 4,44,50,57,72–74,84,85,92,93,95,96,100 comprising 1433 participants reported preoperative physical interventions that consisted of inspiratory muscle training, breathing exercises, respiratory exercises, cycle ergometer training, treadmill, aerobic exercise workouts, and balance and strength training. The main physical outcomes reported were postoperative pulmonary complications, postoperative atelectasis, pulmonary function, pulmonary recovery, postoperative respiratory muscle strength, functional capacity, exercise capacity or performance, physical functioning, frailty, inspiratory muscle strength, blood pressure, lipid levels, and hemoglobin levels.…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary function was the worst on postoperative day 3 and began to improve on day 15. Pulmonary function returned to the preoperative baseline on day 30. Nardi et al , 74 (2020) Italy Retrospective non-randomized n=102 CABG Valve In-hospital Respiratory training with or without musculoskeletal exercise in different intervention groups: 1. Preoperative respiratory physiotherapy 2.…”

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confidence: 99%

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Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review

Olsen

Pedersen

Noergaard

2023

JBI Evidence Synthesis

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The objective of this scoping review was to identify and map existing preoperative interventions, referred to as prehabilitation, in adult patients at home awaiting elective coronary artery bypass grafting surgery. This review also sought to report feasibility and patient experiences to shape clinical practice and underpin a future systematic review. Introduction:As patients age, comorbidities become more common. Strategies to improve postoperative outcomes and to accelerate recovery are required in patients undergoing coronary artery bypass grafting. Prehabilitation refers to a proactive process of increasing functional capacity before surgery to improve the patient's ability to withstand upcoming physiologic stress and, thus, avoid postoperative complications.Inclusion criteria: Studies that included adult patients waiting for coronary artery bypass grafting surgery at home and that described interventions optimizing preoperative physical and psychological health in any setting were included. Methods:The JBI methodology for conducting scoping reviews was used to identify relevant studies in MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library, Embase (Ovid), Scopus, SweMed+, PsycINFO (EBSCOhost), and PEDro. Gray literature was identified searching Google Scholar, ProQuest Dissertations and Theses, MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish, English, German, Norwegian, and Swedish were considered for inclusion, with no geographical or cultural limitations, or date restrictions. Two independent reviewers screened titles and abstracts, and studies meeting the inclusion criteria were imported into Covidence. Sixty-seven studies from November 1987 to September 2022 were included. The data extraction tool used for the included papers was developed in accordance with the review questions and tested for adequacy and comprehensiveness with the first 5 studies by the same 2 independent reviewers. The tool was then edited to best reflect the review questions. Extracted findings are described and supported by figures and tables. Results:Sixty-seven studies were eligible for inclusion, representing 28,553 participants. Analyses of extracted data identified various preoperative interventions for optimizing postoperative and psychological outcomes for adult patients awaiting elective coronary artery bypass grafting surgery. Based on similarities, interventions were grouped into 5 categories. Eighteen studies reported on multimodal interventions, 17 reported on psychological interventions, 14 on physical training interventions, 13 on education interventions, and 5 on oral health interventions. Conclusion:This scoping review provides a comprehensive summary of strategies that can be applied when developing a prehabilitation program for patients awaiting elective coronary artery bypass surgery. Although prehabilitation has been tested extensively and appears to be feasible, available evidence is mostly based on small studies. For patients undergoing elective coronary artery bypass grafting to derive be...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review

Olsen

Pedersen

Noergaard

2023

JBI Evidence Synthesis

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“…The cardiac prehabilitation program should include education, nutritional optimization, exercise training, social support, and anxiety reduction, which enables the patient to withstand the stress of surgery by enhancing functional capacity. The current evidence mainly focuses on the role of preoperative cardiopulmonary and muscle pre rehabilitation in reducing hospital stay and pulmonary complications after cardiac surgery [ 118 ]. Although there is evidence to support that prehabilitation exercise therapy before elective abdominal aortic aneurysm repair can reduce postoperative serum creatinine and the requirement for haemodialysis/haemofiltration [ 119 ], the role of prehabilitation in CSA-AKI remains uncertain.…”

Section: Strategies For Csa-aki Preventionmentioning

confidence: 99%

Diagnosis, pathophysiology and preventive strategies for cardiac surgery-associated acute kidney injury: a narrative review

Zhu

et al. 2023

Eur J Med Res

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Acute kidney injury (AKI) is a common and serious complication of cardiac surgery and is associated with increased mortality and morbidity, accompanied by a substantial economic burden. The pathogenesis of cardiac surgery-associated acute kidney injury (CSA-AKI) is multifactorial and complex, with a variety of pathophysiological theories. In addition to the existing diagnostic criteria, the exploration and validation of biomarkers is the focus of research in the field of CSA-AKI diagnosis. Prevention remains the key to the management of CSA-AKI, and common strategies include maintenance of renal perfusion, individualized blood pressure targets, balanced fluid management, goal-directed oxygen delivery, and avoidance of nephrotoxins. This article reviews the pathogenesis, definition and diagnosis, and pharmacological and nonpharmacological prevention strategies of AKI in cardiac surgical patients.

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“…67,68 However, further research is needed to determine their effect on preventing CSA-AKI. 69,70 The KDIGO Bundle of Care…”

Section: Introductionmentioning

confidence: 99%

Cardiac Surgery–Associated Acute Kidney Injury

Scurt,

Bose,

Mertens

et al. 2024

Kidney360

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Acute kidney injury (AKI) is a common and serious complication of cardiac surgery that has a significant impact on patient morbidity and mortality. The Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI is widely used to classify and identify AKI associated with cardiac surgery (CSA-AKI) based on changes in serum creatinine and/or urine output. There are various pre-, intra-, and postoperative risk factors for the development of CSA-AKI which should be recognized and addressed as early as possible to expedite its diagnosis, reduce its occurrence and prevent or ameliorate its devastating complications. Crucial issues are the inaccuracy of serum creatinine as a surrogate parameter of kidney function in the perioperative setting of cardiothoracic surgery and the necessity to discover more representative markers of the pathophysiology of AKI. However, except for the tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 ratio (TIMP2/IGFBP7), other diagnostic biomarkers with an acceptable sensitivity and specificity are still lacking. This article provides a comprehensive review of various aspects of CSA-AKI, including pathogenesis, risk factors, diagnosis, biomarkers, classification, prevention and treatment management.

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The benefit of a preoperative respiratory protocol and musculoskeletal exercise in patients undergoing cardiac surgery

Cited by 4 publications

References 27 publications

Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review

Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review

Diagnosis, pathophysiology and preventive strategies for cardiac surgery-associated acute kidney injury: a narrative review

Cardiac Surgery–Associated Acute Kidney Injury

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