Thoracic Surgery. Myocardial Ischemia. Physical Therapy Specialty. Cardiovascular diseases. Lung Diseases.
Conditions
Interventions
The number required for the study will be 120 patients in each group, totaling 240 patients. All patients from both groups arriving from the surgical center in the immediate postoperative period of ca
Venous oxygen saturation (SvO2), serum lactate (LAC). Pulse oximetry (SpO2) will also be evaluated and collected. These measures will be collected in three moments: immediately after admission to the
Other
V03.175.250
Sponsors
ICS UFBA
ICS UFBA
Eligibility
Age
18 Years to 96 Years
Inclusion criteria
Inclusion criteria: Older than 18 years. Both sexes. Admitted to the cardiovascular unit of the Ana Nery Hospital. Patients in immediate postoperative cardiac surgery, namely: myocardial revascularization and aortic or mitral valve exchanges, or the combination of these surgeries.
Exclusion criteria
Exclusion criteria: Thoracic deformity. Difficulty or inability to swallow and release airways. No cough reflex. Hemodynamic instability. Psychomotor agitation. Previous pneumectomy. Risk of pleural fistula. Postoperative pulmonary resection. Bullous or cavitary lesions. Hemoptysis. Non-drained pneumothorax. Increased intracranial pressure > 20 mmHg if sustained. Patients with neuromuscular diseases. Neurological complications during the postoperative period. Dependence on mechanical ventilation. Previous cardiac surgery. Chronic obstructive pulmonary disease. Emphysematous Bubbles. Asthma. Morbidly obese. Pulmonary hypertension. Left ventricular dysfunction with ejection fraction lower than 35%. Emergency surgery. Use of ventricular assist device. Arrhythmia associated with hemodynamic instability. Alveolar hemorrhage. Signs of refractory hypoxemia on admission. Pulmonary thromboembolism. Unilateral total atelectasis (a patient with a need for bronchoscopy). Chest wall Trauma. Need to transfer to another hospital.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Post-operative pulmonary complications. If pulmonary complications increased or decreased. The complications considered in this study will be: pneumonia, considered by chest radiography where there is persistent alveolar infiltrate, progressive or consolidation associated with fever (axillary temperature above 37.8 °c), leukopenia (< 4000 LEUC/MM3) or leukocytosis, changes in the aspect of the tracheal secretion (emergence of purulent secretion), wheezing, snoring in the pulmonary auscultation and worsening of the gas exchange. Atelectasis evidenced by chest radiography and presence of crackling rales or wheezing. Pleural effusion and pneumothorax, detected by chest radiography; Pulmonary hemorrhage defined by alveolar infiltrate on chest x-rays, decrease in hemoglobin rates and bronchoalveolar haemorrhagic lavage and Acute respiratory distress syndrome (ARDS), characterized by bilateral pulmonary infiltrate at Chest radiography, compatible with pulmonary edema, severe hypoxemia, defined as PaO2/FIO2 ratio < 200. These complications will be evaluated through chest X-ray exams. | — |
Secondary
| Measure | Time frame |
|---|---|
| It is expected to verify a reduction in the reintubation rate in hours, being analyzed from the number of hours the patient will be on mechanical ventilation, from when it is coupled to mechanical ventilation until its exit.;We want to analyze the length of stay of patients in days in the intensive care unit, this will be observed by the number of days the patient is hospitalized in the ICU. ;We will see in this study the increase or decrease in ICU mortality in percentage and increase or decrease in hospital mortality in percentage. We intend to analyze this by Euroscore and STS Risk, both scores used to verify the mortality and morbidity and mortality of cardiac surgery patients, analyzed in the preoperative period of these patients. | — |
Countries
Brazil
Contacts
Public ContactMansuetto Neto
Departamento de Fisioterapia Instituto de Ciências da Saúde
Outcome results
None listed