Short-term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy

• Published in: Scandinavian Cardiovascular Journal
• Main Authors: Ragnarsdottir, Maria, Kristjansdottir, Asdis, Ingvarsdottir, Ingveldur, Hannesson, Petur, Torfason, Bjarni, Cahalin, Lawrence
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2007
• Subjects: Abdomen; Aged; 80 and over; Cardiac Surgical Procedures; Forced Expiratory Volume; Heart Diseases; Intraoperative Period; Lung; Iceland; Postoperative Period; Respiratory Mechanics; Spirometry; Statistics; Sternum; Thorax; Time Factors; Treatment Outcome; Vital Capacity
• Online Access: http://hdl.handle.net/2336/11831; https://doi.org/10.1080/14017430310016658

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field OBJECTIVE--To study the changes in bilateral respiratory motion and pulmonary function following sternotomy and the relationships between the changes in respiratory movements, spirometry, radiographic analyses, and several intra-operative surgical characteristics. DESIGN--Respiratory motion during deep breathing and lung volumes were measured in 20 patients (mean age 65 years, SD 16) before and after median sternotomy. Chest x-rays were analyzed pre- and postoperatively and a variety of perioperative variables were measured. RESULTS--Average abdominal motion decreased to 57% of preoperative values bilaterally 1 week postoperatively, the average lower thoracic motion decreased to 72%, and the average upper thoracic motion decreased to 87%, whereas the right upper thoracic motion increased 3% compared with preoperative values. Lung volumes decreased to around 60% of preoperative values (p<0.05). Significant correlations were found between the decrease in pulmonary function and the mean respiratory movements. Abnormal chest radiographs were found in all patients. CONCLUSION--The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented.