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早期活动对接受冠状动脉旁路移植术患者的临床及功能结局的影响。

Impact of early mobilization on clinical and functional outcomes in patients submitted to coronary artery bypass grafting.

作者信息

Cordeiro André Luiz Lisboa, Lima Andressa Dos Santos, Oliveira Carliane Moreira De, Sá Jaqueline Purificação De, Guimarães André Raimundo França

机构信息

Doctoral Student in Medicine and Human Health, Bahian School of Medicine and Public Health Salvador, Bahia, Brazil.

Graduated in Physiotherapy from The Noble College Feira de Santana, Bahia, Brazil.

出版信息

Am J Cardiovasc Dis. 2022 Apr 15;12(2):67-72. eCollection 2022.

Abstract

INTRODUCTION

Heart surgery is a feature that has grown a lot in recent years. Due to the complications that can be generated, the importance of prevention emerges, thus seeking effective protocols that generate improvement in clinical and functional outcomes to promote a shorter hospital stay and readmission.

OBJECTIVE

To evaluate the impact of early mobilization on clinical and functional outcomes in patients undergoing coronary artery bypass grafting.

METHODOLOGY

This was a prospective cohort study. Patients were evaluated preoperatively through the Medical Research Council (MRC), Functional Independence Measurement (FIM), Six-Minute Walk Test (6MWT). After the surgery they were divided into two groups: the mobilized group (MG) where patients performed bed transfer to armchair on the 1st postoperative day and ambulated on the 2nd day, and the non-mobilized group (NMG) who underwent passive kinesiotherapy in bed. At ICU discharge, mechanical ventilation (MV) time, intensive care unit stay (ICU) and mortality were compared. At hospital discharge, preoperative tests were repeated to compare with admission.

RESULTS

A total of 103 patients were admitted, 59 (57.3%) males, mean age 64 ± 8 years. Time of MV it was 6 ± 2 (MG) vs 10 ± 3 (NMG) hours, P = 0.02, ICU stay it was 2 ± 2 (MG) vs 4 ± 3 (NMG) days (P ≤ 0.001), length of stay hospital was 8 ± 4 (MG) vs 14 ± 5 (NMG) days (P ≤ 0.001), FIM -4 ± 2 (MG) vs -11 ± 4 (NMG) points (P ≤ 0.001) and distance traveled 37 ± 10 (MG) vs 78 ± 11 (NMG) meters (P < 0.001).

CONCLUSION

Early mobilization is associated with improvement in clinical outcomes such as MV time, ICU stay, hospital and functional outcomes, on the FIM scale and distance traveled.

摘要

引言

心脏手术是近年来发展迅速的一项医疗技术。由于可能产生的并发症,预防的重要性日益凸显,因此需要寻求有效的方案来改善临床和功能结局,以缩短住院时间和再入院率。

目的

评估早期活动对冠状动脉搭桥手术患者临床和功能结局的影响。

方法

这是一项前瞻性队列研究。术前通过医学研究委员会(MRC)、功能独立性测量(FIM)、六分钟步行试验(6MWT)对患者进行评估。术后将患者分为两组:活动组(MG),患者术后第1天从床上转移至扶手椅,并于第2天开始行走;非活动组(NMG),患者在床上接受被动运动疗法。在重症监护病房(ICU)出院时,比较机械通气(MV)时间、重症监护病房停留时间(ICU)和死亡率。在医院出院时,重复术前检查以与入院时进行比较。

结果

共纳入103例患者,其中男性59例(57.3%),平均年龄64±8岁。MV时间为6±2(MG)小时对10±3(NMG)小时,P = 0.02;ICU停留时间为2±2(MG)天对4±3(NMG)天(P≤0.001);住院时间为8±4(MG)天对14±5(NMG)天(P≤0.001);FIM为-4±2(MG)分对-11±4(NMG)分(P≤0.001);行走距离为37±10(MG)米对78±11(NMG)米(P<0.001)。

结论

早期活动与临床结局的改善相关,如MV时间、ICU停留时间、住院时间以及FIM量表和行走距离所反映的功能结局。

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