Changes in lung function and respiratory muscle strength after sternotomy vs. laparotomy in patients without ventilatory limitation
| Autor: | Dario Olivieri, Michele Rusca, Marina Aiello, Paolo Carbognani, Antonio Bobbio, Mario Del Donno, Alfredo Chetta, Roberto Malorgio, Antonio Castagnaro, Andrea Comel |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Resuscitation Adolescent medicine.medical_treatment Respiratory physiology Pulmonary function testing Laparotomy medicine Respiratory muscle Humans In patient Muscle Strength Lung Lung function Aged business.industry Middle Aged Ventilatory defect Respiratory Muscles Respiratory Function Tests Thoracotomy Anesthesia Surgery Female business |
| Zdroj: | European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes. 38(5) |
| ISSN: | 0014-312X |
| Popis: | A relevant ventilatory defect occurs after sternotomy, a very common thoracic surgical opening. The mechanism of the ventilatory impairment is unclear. Moreover, until now, the effect of sternotomy on pulmonary gas exchange has scarcely been investigated. We evaluated the time-course up to recovery and changes in spirometry, maximum static inspiratory (PImax) and expiratory (PEmax) mouth pressures and pulmonary gas exchange in 6 patients after sternotomy and in 8 patients after laparotomy. All patients were free of cardiopulmonary diseases and had normal preoperative lung function. Sternotomy and laparotomy decreased forced vital capacity (FVC) by 67 and 49%, respectively. Moreover, the percent decreases in PImax, PEmax and PaO2 after sternotomy vs. laparotomy were respectively 54 vs. 57%, 54 vs. 60%, and 22.6 vs. 7.5% (p < 0.05). Following sternotomy, the percent decreases in FVC correlated with the percent decreases in PImax (p < 0.05) and PEmax (p < 0.01). The return to baseline values occurred after approximately 2 weeks. The present study shows that sternotomy can induce greater respiratory effects than laparotomy and suggests a relevant involvement of respiratory muscle weakness after surgical opening of the thorax. The study also supports the view that the evaluation of patient’s lung function before sternotomy can be clinically relevant. |
| Databáze: | OpenAIRE |
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