Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry

Journal of Cardiothoracic Surgery

Vitor Oliveira Carvalho¹  Roque Aras²  Erenaldo de Souza Rodrigues²  Marcus Vinicius Herbst Rodrigues¹  Mansueto Gomes Neto³  Michelli Christina Magalhães Novais³  Areli Cunha Pinheiro³ 

[1] Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP (InCor HC-FMUSP), São Paulo, Brazil;Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Bahia, Brazil;Faculdade Social, Salvador, Bahia, Brazil

关键词: exercise;    physiotherapy;    Cardiac surgery;    Vital Capacity;    Assessment;   

Others  :  1154175
DOI  :  10.1186/1749-8090-6-70

 received in 2011-01-03, accepted in 2011-05-12,  发布年份 2011

【 摘 要 】

Background

Measurement of vital capacity (VC) by spirometry is the most widely used technique for lung function evaluation, however, this form of assessment is costly and further investigation of other reliable methods at lower cost is necessary. Objective: To analyze the correlation between direct vital capacity measured with ventilometer and with incentive inspirometer in patients in pre and post cardiac surgery.

Methodology

Cross-sectional comparative study with patients undergoing cardiac surgery. Respiratory parameters were evaluated through the measurement of VC performed by ventilometer and inspirometer. To analyze data normality the Kolmogorov-Smirnov test was applied, for correlation the Pearson correlation coefficient was used and for comparison of variables in pre and post operative period Student's t test was adopted. We established a level of ignificance of 5%. Data was presented as an average, standard deviation and relative frequency when needed. The significance level was set at 5%.

Results

We studied 52 patients undergoing cardiac surgery, 20 patients in preoperative with VC-ventilometer: 32.95 ± 11.4 ml/kg and VC-inspirometer: 28.9 ± 11 ml/Kg, r = 0.7 p < 0.001. In the post operatory, 32 patients were evaluated with VC-ventilometer: 28.27 ± 12.48 ml/kg and VC-inspirometer: 26.98 ± 11 ml/Kg, r = 0.95 p < 0.001. Presenting a very high correlation between the evaluation forms studied.

Conclusion

There was a high correlation between DVC measures with ventilometer and incentive spirometer in pre and post CABG surgery. Despite this, arises the necessity of further studies to evaluate the repercussion of this method in lowering costs at hospitals.

【 授权许可】

   
2011 Pinheiro et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Neder JA, Andreoli S, Castelo-Filho A: Reference values for lung function tests. I.Static volumes. Braz J Med Biol Res 1999, 32:703-17.
• [2]Eaton T, Withy S, Garrett JE: Spirometry in primary care practice. The importance of quality assurance and the impact of spirometry workshops. Chest 1999, 116:416-23.
• [3]Scalan CL, Wilkins RK, Stoller : Fundamentos da terapia respiratória de Egan. 7ª edição. Editora Manole Ltda. São Paulo 2000.
• [4]Rodrigues JC, Cardier JMA, Dussamra MHCF, Nakaie CMA, Almeida MB, Silva Filho LVF, Adde FV: Provas de função pulmonar em crianças e adolescentes. J Pneumol 2002, 28:207-221.
• [5]Mallozi MC: Valores de referencia para espirometria em crianças e adolescentes, calculados a partir de uma amostra da cidade de São Paulo. (Tese). São Paulo: Universidade Federal de São Paulo - Escola Paulista de Medicina 1995.
• [6]Forgiarini LA Jr, Rubleski A, Douglas G, Tieppo J, Vercelino R, Dal Bosco A, Monteiro MB, Dias AS: Evaluation of respiratory muscle strength and pulmonary function in heart failure patients. Arq Bras Cardiol 2007, 89:36-41.
• [7]Newton-John H: Prevention of pulmonary complications in severe Guillain-Barré syndrome by early assisted ventilation. Med J Aust 1985, 142:444-5.
• [8]Yavagal DR, Mayer SA: Respiratory complications of rapidly progressive neuromuscular syndromes: Guillain-Barré syndrome and myasthenia gravis. Semin Respir Crit Care Med 2002, 23:221-9.
• [9]Vargas FS, Terra-Filho M, Hueb W, Teixeira RL, Cukier A, Light RW: Pulmonary function after coronary artery bypass surgery. Respir Med 1997, 91:629-33.
• [10]Guizilini S, Faresin SM, Carvalho ACC, Jaramillo JI, Alves FA, et al.: Effects of the pleural drain site on the pulmonary function after coronary artery bypass grafting. Rev Bras Cir Cardiovasc 2004, 19:47-54.
• [11]Taggart DP, El-Fiky M, Carter R, Bowman A, Wheatley DJ: Respiratory dysfunction after uncomplicated cardiopulmonary bypass. Ann Thorac Surg 1993, 56:1123-8.
• [12]Renault JA, Val RC, Rossetti MB: Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca. Rev Bras Cir Cardiovasc 2008, 23:562-9.
• [13]Lichtenberg A, Hagl C, Harrier W, Klima U, Haverich A: Effects of minimal invasive coronary artery bypass on pulmonary function and postoperative pain. Ann Thorac Surg 2000, 70:461-5.
• [14]Giacomazzi CM, Lagni VB, Monteiro MB: Does the pain disturb the respiratory function after open heart surgery? Rev Bras Cir Cardiovasc 2009, 24:490-496.
• [15]Dias CM, Plácido TR, Ferreira MFB, Guimarães FS, Menezes SLS: Incentive spirometry and breath stacking: effects on the inspiratory capacity of individuals submitted to abdominal surgery. Rev Bras Fisioter 2008, 12:94-9.
• [16]Ropper AH: Critical care of Guillain-Barre syndrome. In Ropper AH, ed Neurological and neurosurgical intensive care. New York, Raven Press; 1993:p371.
• [17]Barreto SSM: Volumes pulmonares. J Pneumol 2002, 28:83-94.
• [18]Boskabady MH, Keshmiri M, Banihashemi B, Anvary K: Lung function volues in healthy non-smoking urban adults in iran respiration. JPMA 2002, 69(4):320-6.
• [19]Memon MA, Sandila MP, Ahmed ST: Spirometry reference values in healltlly, now smoking, urban pakistani population. J Pak Med Assoc 2007, 57:193-5.
• [20]Bosoglu OK, Atasever A, Bakakoglu F: The efficacy of incentive spirometry in patients with COPD. Respirology 2005, 10:349-353.
• [21]Agostini P, Calvert R, Subramanian H, Naidu B: Is incentive spirometry effective following thoracic surgery? Interactive Cardiovascular and Thoracic Surgery 2008, 7:297-300.
• [22]Rouquayrol MZ, Almeida Filho N: Epidemiologia a Saúde. 6 ed. Editora Medsi. São Paulo 2003.
• [23]Aquino LM, Branco JNR, Bernardelli GF: Short-duration transcutaneous electrical nerve stimulation in the postoperative period of cardiac surgery. Arq Bras Cardiol 2010, 94:325-31.
• [24]Domholdt E: Physical therapy research; Principles and Applications. 2nd edition. WB Saunders Company, USA; 2000.
• [25]Lopes AA: Medicina baseada em evidencias: a arte de aplicar o conhecimento cientifico na prática clínica. Rev Assoc Med Bras 2000, 46:285-288.
• [26]America Thoracic Society/European Respiratory Society. ATS/ERS statement on respiratory muscle testing Am J Respir Crit Care Med 2002, 166:518-624.
• [27]Sociedade Brasileira de Pneumologia e Tisiologia. Diretrizes para testes de função pulmonar J Pneumol 2002, 28:S1-S238.
• [28]Chevrolet JC, Deleamont P: Repeated vital capacity measurements as predictive parameters for mechanical ventilation need and weaning success in Guillain-Barré syndrome. Am Rev Respir Dis 1991, 144:814-8.
• [29]Suesada MM, Martins MA, Carvalho CR: Effect of short-term Hospitalization on functional capacity in patients not restricted to Bed. Am J Phys Med Rehadil 2007, 86:455-62.
• [30]Ropper AH: Acute inflammatory post infectious polyneuropathy. In Neurological and Neurosurgical Intensive Care. Edited by Roppere AH, Kennedy SF. Gaitherburg, MD Aspen Publications; 1991.