Cardiac Prehabilitation

The care of patients undergoing cardiac surgery is becoming more complex, in part owing to the increasing burden of comorbid disease, frailty, and psychosocial issues. Many risk factors for postoperative morbidity and mortality are potentially modifiable if identified and treated in a timely fashion before surgery. Cardiac prehabilitation, draws from strategies currently undertaken in cardiac rehabilitation but implements them proactively rather than reactively. There is substantial evidence that in multiple domains, including aerobic conditioning, respiratory muscle training, lifestyle modification, diabetic control, sleep, and psychoeducation, selected interventions before cardiac surgery may improve outcomes. However, the optimal preoperative program remains unclear and there is an unmet need for a comprehensive evaluation of the range of interventions specifically targeted at modifiable perioperative risk factors that may reduce adverse outcomes after cardiac surgery. The care of patients undergoing cardiac surgery is becoming more complex, in part owing to the increasing burden of comorbid disease, frailty, and psychosocial issues. Many risk factors for postoperative morbidity and mortality are potentially modifiable if identified and treated in a timely fashion before surgery. Cardiac prehabilitation, draws from strategies currently undertaken in cardiac rehabilitation but implements them proactively rather than reactively. There is substantial evidence that in multiple domains, including aerobic conditioning, respiratory muscle training, lifestyle modification, diabetic control, sleep, and psychoeducation, selected interventions before cardiac surgery may improve outcomes. However, the optimal preoperative program remains unclear and there is an unmet need for a comprehensive evaluation of the range of interventions specifically targeted at modifiable perioperative risk factors that may reduce adverse outcomes after cardiac surgery. Analysis of the Quality of Life Is a Prerequisite for Any Prehabilitation ProgramJournal of Cardiothoracic and Vascular AnesthesiaVol. 34Issue 4PreviewIn their review of “cardiac prehabilitation,”1 the authors introduced cardiac prehabilitation as preventive interventions for cardiac surgery candidates aiming at reducing postoperative complications. These interventions are not limited to physical exercises and also include comments on improving psychological factors.1,2 Similarly, the Enhanced Recovery After Surgery Society employed exactly the same term of “prehabilitation” in their recent guideline for preparation of patients for cardiac surgery to indicate the crucial importance of its role in perioperative period. Full-Text PDF