Menezes Thayse Campos de, Bassi Daniela, Cavalcanti Ricardo César, Barros Juliana Emanuelle Santos Luz, Granja Karolyne Soares Barbosa, Calles Ana Carolina do Nascimento, Exel Ana Luiza
Departamento de Fisioterapia, Centro Universitário Tiradentes - Maceió (AL), Brasil.
Departamento de Fisioterapia, Universidade Ceuma - São Luís (MA), Brasil.
Rev Bras Ter Intensiva. 2018 Oct-Dec;30(4):479-486. doi: 10.5935/0103-507X.20180069.
To evaluate respiratory and peripheral muscle strength after cardiac surgery. Additionally, we compared the changes in these variables on the third and sixth postoperative days.
Forty-six patients were recruited, including 17 women and 29 men, with a mean age of 60.50 years (SD = 9.20). Myocardial revascularization surgery was performed in 36 patients, replacement of the aortic valve in 5 patients, and replacement of the mitral valve in 5 patients.
A significant reduction in respiratory and peripheral muscle strength and a significant increase in pain intensity were observed on the third and sixth postoperative days (p < 0.05), except for the variable maximal inspiratory pressure; on the sixth postoperative day, maximal inspiratory pressure values were already similar to the preoperative and predicted values (p > 0.05). There was an association between peripheral muscle strength, specifically between maximal expiratory pressure preoperatively (rs = 0.383; p = 0.009), on the third postoperative day (rs = 0.468; p = 0.001) and on the sixth postoperative day (rs = 0.311; p = 0.037). The effect sizes were consistently moderate-to-large for respiratory muscle strength, the Medical Research Council scale and the visual analog scale, in particular between preoperative assessment and the sixth postoperative day.
There is a decrease in respiratory and peripheral muscle strength after cardiac surgery. In addition, maximal expiratory pressure is the variable that is most associated with peripheral muscle strength. These variables, especially respiratory and peripheral muscle strength, should be considered by professionals working in the intensive care setting.
评估心脏手术后的呼吸和外周肌肉力量。此外，我们比较了术后第三天和第六天这些变量的变化。
招募了46名患者，其中17名女性和29名男性，平均年龄为60.50岁（标准差=9.20）。36名患者进行了心肌血运重建手术，5名患者进行了主动脉瓣置换，5名患者进行了二尖瓣置换。
术后第三天和第六天观察到呼吸和外周肌肉力量显著降低，疼痛强度显著增加（p<0.05），除了最大吸气压力变量；术后第六天，最大吸气压力值已与术前和预测值相似（p>0.05）。外周肌肉力量之间存在关联，特别是术前（rs=0.383；p=0.009）、术后第三天（rs=0.468；p=0.001）和术后第六天（rs=0.311；p=0.037）的最大呼气压力之间。对于呼吸肌肉力量、医学研究委员会量表和视觉模拟量表，效应大小始终为中度至大，特别是在术前评估和术后第六天之间。
心脏手术后呼吸和外周肌肉力量会下降。此外，最大呼气压力是与外周肌肉力量最相关的变量。重症监护环境中的专业人员应考虑这些变量，尤其是呼吸和外周肌肉力量。
