Açık kalp ameliyatı sonrasında uygulanan farklı fizyoterapi yaklaşımlarındaki hemodinamik etkilerin karşılaştırılması

Abstract

52 SUMMARY Standard Chest Physiotherapy was applied to 20 patients (I. Group) of 53.15±13.18 mean age who underwent open heart surgery in the Medical University of Dokuz Eylül, Department of Chest-Heart Surgery; and incentive spyrometer was applied to 20 patients (II. Group) of 54. 7± 10.42 mean age. For both group of patients following surgical extubation, invasive hemodynamic measurements were taken before, during and after the first physiotherapy treatment and results were compared. SBP, HR, CI, PA-S, PA-D, CVP, PKWP and PVR parameters were noted higher at end of exercise, while DBP and SVR parameters showed decrease in Chest Physiotherapy Group. Only the increase rate in CI was noticeable (p<0.05). Looking at change of rate in incentive spyrometer group, raise was noted in DBP, HR, PA-S, CVP, SVR and PVR, but fall in SBP, CI and PKWP. These alterations were not of importance statistically. Looking at maximum changes noted before and during exercise in Chest Physiotherapy Group, DBP and SVR showed decrease while the rest showed increase. Increase in rate of CI was noticeable (p< 0.02). In incentive spyrometer gorup, no change of importance in any parameter was noted.53 As a result, it was seen that acute effects on hemodynamics of both physical therapy methods applied during early post-op period did not differ and that both methods are trustable. Additionally, noting that CI was noticeably increased without change in heart rate only in chest physiotherapy group, we can say that this method of treatment has more positive effects on clinical follow-up of patients.

52 SUMMARY Standard Chest Physiotherapy was applied to 20 patients (I. Group) of 53.15±13.18 mean age who underwent open heart surgery in the Medical University of Dokuz Eylül, Department of Chest-Heart Surgery; and incentive spyrometer was applied to 20 patients (II. Group) of 54. 7± 10.42 mean age. For both group of patients following surgical extubation, invasive hemodynamic measurements were taken before, during and after the first physiotherapy treatment and results were compared. SBP, HR, CI, PA-S, PA-D, CVP, PKWP and PVR parameters were noted higher at end of exercise, while DBP and SVR parameters showed decrease in Chest Physiotherapy Group. Only the increase rate in CI was noticeable (p<0.05). Looking at change of rate in incentive spyrometer group, raise was noted in DBP, HR, PA-S, CVP, SVR and PVR, but fall in SBP, CI and PKWP. These alterations were not of importance statistically. Looking at maximum changes noted before and during exercise in Chest Physiotherapy Group, DBP and SVR showed decrease while the rest showed increase. Increase in rate of CI was noticeable (p< 0.02). In incentive spyrometer gorup, no change of importance in any parameter was noted.53 As a result, it was seen that acute effects on hemodynamics of both physical therapy methods applied during early post-op period did not differ and that both methods are trustable. Additionally, noting that CI was noticeably increased without change in heart rate only in chest physiotherapy group, we can say that this method of treatment has more positive effects on clinical follow-up of patients.