Gül Deniz YILMAZ YELVAR, Yasemin ÇIRAK, Zehra KARAHAN, İlknur ERDEN, Ufuk DEMİRKILIÇ

Is physiotherapy effective on the occurrence of postoperative pulmonary complications in patients undergoing coronary artery bypass graft surgery? A randomized controlled trial

Amaç: Bu çalışmada koroner arter baypas greft (KABG) cerrahisiyapılan ameliyat sonrası farklı pulmoner komplikasyon risk profilinesahip hastalarda, spesifik bir fizyoterapi protokolünün ameliyatsonrası pulmoner komplikasyon gelişimi, yoğun bakım ünitesinde(YBÜ) ve hastanede kalış süresi ve entübasyon süresi üzerine etkileriaraştırıldı. Çalışmaplanı:Haziran 2012 - Ekim 2014 tarihleri arasında kliniğimizdeKABG ameliyatı yapılan 170 hasta (116 erkek, 54 kadın; ort. yaş57.0±10.0 yıl; dağılım 30-79 yıl) risk skorlarına göre (düşük ≤1 puanveya yüksek ≥2 puan) iki risk grubuna ayrıldı. Dört fazdan oluşanbir fizyoterapi protokolü başlangıçtan taburculuğa kadar uygulandı.Ameliyat sonrası pulmoner komplikasyon insidansı, kör bir araştırmacıtarafından 1-4lük bir ölçek ile derecelendirildi. Fonksiyonel kapasitealtı dakikalık yürüme testi (6DYT) ile değerlendirildi. Anksiyete vedepresyon için Hastane Anksiyete ve Depresyon Skalası (HADS) veyaşam kalitesi için Kısa Form-36 uygulandı. Bul gu lar: Düşük risk grubuna kıyasla, yüksek risk grubunda ameliyatsonrası pulmoner komplikasyon insidansı, hastanede ve YBÜde kalışsüresi ve entübasyon süresi istatistiksel olarak anlamlı değildi (p>0.05).Tüm hastaların 6DYT mesafesinde başlangıca kıyasla taburculuğa kadaranlamlı bir düşüş görüldü; ancak düşüş yüksek risk grubunda daha azdı.Tedavi sonrası gruplar arasında yaşam kalitesi ve depresyon skorlarıaçısından istatistiksel olarak anlamlı bir fark yoktu (p>0.05). Tedavisonrası gruplar arasında anksiyete skorları açısından istatistiksel olarakanlamlı bir fark gözlendi (p

Koroner arter baypas greft cerrahisi yapılan hastalarda ameliyat sonrası pulmoner komplikasyon gelişiminde fizyoterapi etkili midir? Randomize kontrollü çalışma

Background: This study aims to investigate the efficacy of a specificphysiotherapy protocol on the occurrence of postoperative pulmonarycomplications, length of intensive care unit (ICU) and hospital stay,and duration of intibutation in patients undergoing coronary arterybypass graft (CABG) surgery with variable postoperative pulmonarycomplication risk profiles. Methods: Between June 2012 and October 2014, a total of 170 patients(116 males, 54 females; mean age 57.0±10.0 years; range 30 to 79 years)who underwent CABG surgery in our clinic were divided into two riskgroups on the basis of their risk scores (low-risk ≤1 point or high-risk ≥2point). A physiotherapy protocol consisted of four phases was performedfrom baseline until discharge. The incidence of postoperative pulmonarycomplications was scored by a blinded investigator on an ordinal scaleof 1 to 4. Functional capacity was evaluated using a six-minute walk test(6MWT). Hospital Anxiety and Depression Scale (HADS) for anxietyand depression and Short Form-36 for quality of life were applied. Results: The incidence of postoperative pulmonary complications,length of stay in the hospital and ICU and duration of intubation werenot statistically significant in high-risk group, compared to the low-riskgroup (p>0.05). There was a significant decrease in 6MWA distance frombaseline to discharge for all patients; however, the decline was lower inhigh-risk group. There was no statistically significant differences in thequality of life and depression scores between the groups after treatment(p>0.05). We observed statistically significant differences in anxietyscores between the groups after treatment (p

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