Document Detail


Chest wall motion and pulmonary function are more diminished following cardiac surgery when the internal mammary artery retractor is used.
MedLine Citation:
PMID:  15804805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Pulmonary complications following cardiac surgery through sternotomy have been widely studied. The duration of these complications, however, has been less studied and the proposed alterations in chest wall mechanism even less. The purpose of this study was to investigate changes in chest wall motion and pulmonary function of cardiac surgery patients, where both the median and the internal mammary artery retractor was used (IMA group) and cardiac surgery patients, where only the median retractor was used (Median group). DESIGN: Subjects were 20 cardiac surgery patients with mean age 65 years (12 in the IMA group and 8 in the Median group). Bilateral respiratory movements (RMs) using the Respiratory Movement Measuring Instrument, lung volumes including vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume (FEV1) using the Vitalograph Alpha were measured and pulmonary radiographs analyzed before, 3 and 12 months after the operation. ANALYSIS: Descriptive statistics, t-tests, Mann-Whitney and Wilcoxon Signed Rank tests were used for analyses, p < or = 0.05. RESULTS: RMs were symmetrical in both groups prior to the operation and the differences in RMs and lung volumes between the groups were not significant. Three and 12 months postoperatively bilateral abdominal respiratory movements (ARM) were significantly less in the IMA group than in the Median group. Average left ARM were significantly less than the average right ARM in the IMA group 3 months postoperatively, while symmetrical in the Median group. Average FVC and FEV1 were significantly less in the IMA group than in the Median group 3 months postoperatively and FVC was still significantly less in the IMA group 12 months after the operation. CONCLUSION: The significantly more reduced ARM and lung volumes 3 months postoperatively in the IMA group than in the Median group suggests that the IMA retractor causes greater injury to the rib cage and the diaphragm.
Authors:
Asdís Kristjánsdóttir; María Ragnarsdóttir; Pétur Hannesson; Hans Jakob Beck; Bjarni Torfason
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  38     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-04-04     Completed Date:  2005-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  369-74     Citation Subset:  IM    
Affiliation:
Landspítali University Hospital, Reykjavík, Iceland. asdiskri@landspitali.is
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MeSH Terms
Descriptor/Qualifier:
Abdominal Muscles / physiology
Aged
Cardiac Surgical Procedures / adverse effects*,  instrumentation*,  methods
Humans
Middle Aged
Movement / physiology
Respiratory Function Tests
Sternum / surgery*
Thoracic Wall / physiology*
Vital Capacity / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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