医学
康复
随机对照试验
冠状动脉搭桥手术
心脏外科
动脉
临床终点
最大VO2
体外循环
物理疗法
肺康复
肺活量
麻醉
内科学
心脏病学
肺
心率
肺功能
血压
扩散能力
作者
Maurice Zanini,Rosane Maria Nery,Juliana Beust de Lima,Raquel Petry Bühler,Anderson Donelli da Silveira,Ricardo Stein
出处
期刊:Journal of Cardiopulmonary Rehabilitation and Prevention
[Ovid Technologies (Wolters Kluwer)]
日期:2019-07-24
卷期号:39 (6): E19-E25
被引量:54
标识
DOI:10.1097/hcr.0000000000000431
摘要
Patients undergoing coronary artery bypass graft (CABG) surgery typically experience loss of cardiopulmonary capacity in the post-operative period. The purpose of this study was to evaluate the effects of different rehabilitation protocols used in inpatient cardiac rehabilitation on functional capacity and pulmonary function in patient status post-CABG surgery.This was a single-blind randomized controlled trial. The primary endpoint of functional capacity and secondary endpoints of lung capacity and respiratory muscle function were assessed in patients scheduled to undergo CABG. After surgery, 40 patients were randomly assigned across 1 of 4 inpatient cardiac rehabilitation groups: G1, inspiratory muscle training, active upper limb and lower limb exercise training, and early ambulation; G2, same protocol as G1 without inspiratory muscle training; G3, inspiratory muscle training alone; and G4, control. All groups received chest physical therapy and expiratory positive airway pressure. Patients were reassessed on post-operative day 6 and post-discharge day 30 (including cardiopulmonary exercise testing).The 6-min walk distance on post-operative day 6 was significantly higher in groups that included exercise training (G1 and G2), remaining higher at 30 d post-discharge (P < .001 between groups). Peak oxygen uptake on day 30 was also higher in G1 and G2 (P = .005). All groups achieved similar recovery of lung function.Protocols G1 and G2, which included a systematic plan for early ambulation and upper and lower limb exercise, attenuated fitness losses while in the hospital and significantly enhanced recovery 1 mo after CABG.
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