Prophylactic inspiratory muscle training in patients undergoing coronary artery bypass graft
Prophylactic inspiratory muscle training in patients undergoing coronary artery bypass graft
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DOI：
10.1007/s002689900410
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发表时间：
1998-05-01
影响因子：
2.6
通讯作者：
Weiner, M
中科院分区：
文献类型：
--
作者：
Weiner, P;Zeidan, F;Weiner, M
心脏手术后肺部并发症是导致术后并发症和死亡的主要原因之一，呼吸肌无力可能是导致术后肺部异常的原因之一（残余容量时的PI最大值）和耐久性冠状动脉旁路移植术（CABG）后的Pm-峰值/PImax;（2）这种虚弱与肺功能测试（PFT）降低、气体交换受损和肺部并发症发生率较高有关;（3）预防性吸气肌训练（IMT）可预防上述改变。84例年龄33 ~ 82岁的择期CABG患者随机分为两组：A组（42例）术前1个月进行IMT阈值训练，每天30 min，共2周; 42例患者作为对照组，接受假训练（B组），呼吸肌功能、PFT、对照组CABG后的气体交换，而训练组的这些参数与进入研究前相似。两组之间的差异有统计学意义。此外，对照组中有11例（26%）患者需要术后机械通气超过24小时，而训练组中只有2例（5%）患者需要术后机械通气超过24小时。CABG对吸气肌功能、PFT和动脉血气具有显著的恶化作用，这些参数的降低可以通过预防性吸气肌训练来预防，这也可以预防术后肺部并发症。
Pulmonary complications after cardiac surgery are a leading cause of postoperative morbidity and mortality, Respiratory muscle weakness may contribute to the postoperative pulmonary abnormalities, We hypothesized that: (1) there is a decrease in inspiratory muscle strength (PImax at residual volume) and endurance (Pm-peak/PImax) following coronary artery bypass graft (CABG); (2) this weakness is associated with reduced pulmonary function tests (PFTs), impaired gas exchange, and a higher rate of pulmonary complications; and (3) prophylactic inspiratory muscle training (IMT) can prevent those changes. Eighty-four candidates for CABG, with ages ranging from 33 to 82 years, were evaluated prior to operation and randomized into two groups: 42 patients underwent IMT using a threshold trainer for 30 min/day for 2 weeks, 1 month before operation (group A); 42 patients served as a control group and underwent sham training (group B), There nas a significant decrease in respiratory muscle function, PFTs, and gas exchange in the control group following CABG, whereas these parameters remained similar to those before entering the study in the training group. The differences between the groups were statistically significant, In addition, 11 (26%) patients in the control group but only 2 (5%) in the training group needed postsurgical mechanical ventilation longer than 24 hours. CABGs have a significant deteriorating effect on inspiratory muscle function, PFTs, and arterial blood gases, The decrease in these parameters can be prevented by prophylactic inspiratory muscle training, which may also prevent postsurgical pulmonary complications.