Koroner Arter Bypass Greftleme Sonrası Yoğun Bakımda Uygulanabilecek Güvenli Alt Ekstremite Egzersiz Modelleri: Bisiklet Ergometresi ve Tüm Vücut Titreşimi

Koroner arter bypass greftleme, koroner arter rahatsızlıklarında sıklıkla kullanılan cerrahi bir yöntemdir. Bu yöntemin uygulanma sıklığı da gün geçtikçe artmakta ve bu da bu operasyonu geçirmiş hasta sayısının artmasına ve böylece bu hastalarda, operasyon sonrası fonksiyonel ve solunumsal değerlerde ani düşüşlere yol açmaktadır. Koroner arter bypass greftleme operasyonu sonrasında hastaların yoğun bakım süreçlerinin başlamasıyla birlikte, eğer hastalar mobilize edilmezlerse, bir immobilizasyon süreci başlar ve bu da hastalarda yoğun bakım kaynaklı kas zayıflıklarına, solunumsal ve fonksiyonel problemlere yol açabilir. Bu komplikasyonların üstesinden gelebilmek için, özellikle uyutulan ve/veya mekanik ventilatöre bağlı olan hastaların, yoğun bakımdayken erken mobilizasyona katılımlarını sağlamak için Koroner arter bypass greftleme opareasyonu sonrası güvenle uygulanabilecek egzersiz modellerine ihtiyaç vardır. Hem bisiklet ergometresinin, hem de tüm vücut titreşim cihazlarının pasif egzersiz modlarının olduğu ve Koroner arter bypass greftleme operasyonundan sonra sternal önlemlerden dolayı hastaların üst ekstremitelerine getirilen kısıtlamalara uymaları gerektiği düşünüldüğünde, sadece alt ekstremiteleri çalıştırma olanağı veren bu iki egzersiz modellinin yoğun bakım hastalarına olan etkilerini araştırılması gereklilik haline gelmiştir. Bu derleme, BE ve TVT egzersiz modellerinin, KABG sonrasındaki yoğun bakım sürecinde erken mobilizasyona destek olma, katılımı artırma, immobilizasyona bağlı olarak gelişen çeşitli fiziksel ve fizyolojik komplikasyonların önüne geçmede faydalı olabileceği sonucuna varmaktadır.

Anahtar Kelimeler:

Koroner arter bypas greftleme, Bisiklet Ergometresi, Tüm Vücut Titreşimi, Yoğun Bakım, Alt Ekstremite

Safe Lower-extremity Exercise Models That Could Be Implemented In Intensive Care Units Following Coronary Artery Bypass Grafting: Cycle Ergometer and Whole-Body Vibration

Coronary artery bypass grafting is a surgical method used to treat coronary artery diseases. The frequency of administering this method is increasing every day and this leads to an increase in the number of patients who have undergone this operation, thus more patients experience sudden decreases in postoperative functional and respiratory values in those patients. After the start of the intensive care part of the patients' treatment plan following the coronary artery bypass grafting operation, an immobilization period begins if the patients are not mobilized, and this may lead to an intensive care unit acquired muscle weaknesses, respiratory and functional problems. In order to overcome these complications, it is clear that exercise models that can be safely implemented after the coronary artery bypass grafting operation are needed to promote early mobilization of patients who are sedated and/or mechanically ventilated during their intensive care unit stays. Considering that both the cycle ergometer and the whole body vibration devices have passive exercise modes and that patients must comply with the restrictions imposed on their upper extremities due to sternal precautions following the coronary artery bypass grafting operation, it has become a necessity to investigate the effects of these two exercise models that allow only the lower extremities to work in intensive care unit patients. This review concluded that BE and TVT exercise models may be useful in promoting early mobilization, increasing participation, and preventing various physical and physiological complications associated with immobilization during their stay in the intensive care units following CABG.

Keywords:

Coronary artery bypass grafting, Cycle ergometer, Whole-body vibration, Intensive care, Lower extremity,

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