A 56-year-old man with end-stage heart failure performed a 4-week, symptom-limited, progressive inpatient cardiac prehabilitation program while confined to the cardiovascular intensive care unit awaiting heart transplantation. Mobility was limited by an acute gout flare and multiple central venous access lines. He received a tailored prescription of intermittent boxing, supervised hallway ambulation, stair training, and golfing on a putting green on four consecutive weekdays and was encouraged to mobilize with nursing on the remaining days. The patient progressed and by the last week demonstrated increased activity tolerance. He had a successful transplant after 40 days in the intensive care unit and was discharged with stamina sufficient to participate in outpatient cardiac rehabilitation, demonstrating the value, safety, and feasibility of an individualized inpatient cardiac prehabilitation program for patients with advanced cardiac disease medically confined to the intensive care unit.
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http://dx.doi.org/10.1080/08998280.2020.1818050 | DOI Listing |
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
Although cardiovascular anesthesiologists play a role in the multidisciplinary heart team, they are generally not involved prior to the diagnosis of coronary artery disease. This work was designed to broadly cover the factors influencing decision-making when proceeding with coronary angiography in a patient with suspected coronary artery disease. The authors cover the principles, rationale, benefits, and downsides of common tests involved.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Ankara Training and Research Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Background: Incentive spirometer is used in lung expansion therapy to maintain alveolar patency and improve pulmonary volumes in postoperative cardiac surgical patients. Deep breathing exercises with an incentive spirometer significantly reduce the development of postoperative pulmonary complications after open-heart cardiac surgery.
Aim: To determine the effect of deep breathing exercises with an incentive spirometer initiated in the preoperative period on respiratory parameters and complications in patients who underwent open-heart surgery.
Anaesthesia
January 2025
Department of Anaesthesiology, Institute of Science Tokyo Hospital, Bunkyo, Tokyo, Japan.
Introduction: Assessment of functional capacity is an essential part of peri-operative risk stratification. Subjective functional capacity is easier to examine than objective tests of patient fitness. However, the association between subjective functional capacity and postoperative outcomes has not been established.
View Article and Find Full Text PDFOpen Heart
January 2025
Department of Cardiothoracic and Vascular Surgery, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Aims: Exercise testing remains underused in patients with aortic stenosis (AS), partly due to concerns about an exercise-induced drop in systolic blood pressure (SBP). We aimed to study the SBP response to exercise in patients with severe symptomatic AS prior to surgery and 1 year postoperatively.
Methods: Patients scheduled for aortic valve replacement due to severe symptomatic AS were enrolled at a single centre in a prospective observational cohort study.
Nurs Crit Care
January 2025
Department of Intensive Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Background: Tracheal extubation failure after cardiac surgery is associated with diminished cough strength, albeit the information on cough strength in post-cardiac surgery patients is limited.
Aim: To investigate the cough strength in patients after cardiac surgery before tracheal extubation and the related influencing factors.
Study Design: A cross-sectional study was designed, with adherence to the STROBE guidelines.
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