Heart; Dysfunction Postoperative, Cardiac Surgery Clinical Trial
Official title:
Follow-up Study of Functional Capacity and Respiratory Muscle Strength in Patients Undergoing Cardiac Surgery
Countless studies are performed to quantify the severity of heart disease and its influence
on the respiratory system, checking that their heart conditions and the surgical process
determine pulmonary complications, one of the most common causes of morbidity and mortality
in the postoperative period of cardiac surgery . After surgical procedures, there is a
reduction of the residual volume (RV), total lung capacity (TLC), vital capacity (VC) and
functional residual capacity (FRC), leading to the formation of atelectasis, with
alterations in the ventilation-perfusion ( V / Q), the partial pressure of carbon dioxide in
arterial blood (PaCO2) and partial pressure of oxygen in arterial blood (PaO 2).
Pulmonary function is impaired in the postoperative period of cardiac surgery, due to
various factors common to this major surgery that will drive the patient to develop
respiratory complications such as atelectasis and pneumonia. Physical therapy plays an
important role in the treatment of patients undergoing cardiac surgery, both in the
preoperative period and postoperative, in order to prevent or minimize the respiratory
complications.
Follow-up studies on cardiac rehabilitation quantify the quality of all the activities
necessary to ensure to patients with heart disease patients the best physical , mental and
social conditions so that consequently they are able , with its effort to regain a normal
position in the community and lead a active and productive life over time, therefore, the
clinical changes resulting from an extensive cardiac surgery are already highly dedicated
described in literature but which daily life factors or rehabilitation interventions that
the patient will take in the late postoperative period that really assisted in his complete
recovery and inclusion into society they are still not well elucidated , so it is
appropriate to carry out this project due to the fact exposed to up.
The project to be developed whose main justification clarify issues related to the return or
preservation of the individual feature that undergoes extensive cardiac procedure , as well
as incidence of mortality after 12 months of the procedure. The current literature does not
expressed clearly, possible impacts on functionality and return the daily activities of the
individual in the late postoperative period , since such malfunctions in the immediate post
operative period are already fully understood.
Will be held during the period from August to November 2015, quantitative descriptive
transversal study with patients in the late postoperative period and who underwent cardiac
surgery in a hospital of medium complexity in state of sao paulo , Brazil in the period to
one year of the procedure. Patients will be recruited via contact by phone to attend in
place with certain pre scheduled time for carrying out assessments relevant to the study.
Evaluations shall be performed in hospital in predetermined track, under the sun and
accompanied by the examiners. All individuals will be properly oriented and participate in
the activities after signing the informed consent (Informed Consent and Informed).
Will be held primarily refers to report cards and progress retroactive filled by students
physiotherapy course that evaluated the functional condition and respiratory muscle strength
of these individuals included in the study at the time of hospital discharge in cardiac
surgical post (last year). The purpose of the consultation of these records is to determine
the functional clinical characteristics of these individuals soon after surgery to
corroborate the results of these same tests in these patients one year after participants'
surgery as well being able to quantify the influence of a number of situations that occurred
in the lives of these individuals who may modify in any way the current situation both
clinical and social thereof. These evaluation sheets are filed at the physiotherapy clinic.
After consulting retroactive chips, a full interview will be held with the participant,
assessing quality of life through specific scores (SF-36), evaluation of daily living
habits, social life, work life, independence, recurrent admissions this the participation
period of rehabilitation programs and cease habits like smoking, drinking and physical
inactivity.
The clinical trials will be conducted: quantification of inspiratory and expiratory muscle
strength through the determination of maximal inspiratory pressure (MIP.) And maximal
expiratory pressure (MEP.) Using the device which measures and submaximal functional testing
through the application of Walk Test 6 minutes (TC6`).
The patient will be taken to the track to be traveled for the test and hemodynamic data were
to be collected at rest, during and after the test are: blood pressure, heart rate, oxygen
saturation.
The patient should be instructed to walk as fast as you can without running, as recommended
by the American ThoracicSociety, on a track of 30 meters, marked every 3 meters, with the
turning point. By completing the six minutes, the patient should stop immediately. In this
way it will be measured the total distance covered by the patient and again all variables at
the time of arrest.
The parameters checked during the whole test should be noted , as the distance traveled in
meters.
At the end of quantification of clinical and epidemiological data, previous history and
current data comparison will be made in order to determine the physical and functional
characteristics of these patients in monitoring the late postoperative period .
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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