Koroner Bypass`tan sonra erken göğüs fizyoterapisinin kardiyopulmoner etkilerinin araştırılması
Evaluation of hemodynamic benefits of early chest physiotherapy after coronary bypass surgery
- Tez No: 49434
- Danışmanlar: Y.DOÇ.DR. YÜCEL YILDIRIM
- Tez Türü: Yüksek Lisans
- Konular: Fiziksel Tıp ve Rehabilitasyon, Göğüs Kalp ve Damar Cerrahisi, Physical Medicine and Rehabilitation, Thoracic and Cardiovascular Surgery
- Anahtar Kelimeler: Koroner Bypass, Göğüs Fizyoterapisi, Pozisyon, hemodinami, Göğüs, Koroner arter bypass, Postoperatif bakım, Thorax, Hemodynamics, Coronary artery bypass, Postoperative care
- Yıl: 1996
- Dil: Türkçe
- Üniversite: Dokuz Eylül Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Belirtilmemiş.
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
ÖZET
Özet (Çeviri)
ABSTRACT Key Words; Coronary Bypass, Chest Physiotherapy» Position, Hemodynamic Arterial Blood Gas Analysis. EVALUA TION OF HEMODYNAMIC BENEFITS OF EARLY CHEST PHYSIOTHERAPY AFTER CORONARY BYPASS SURGERY AB CIMBIZ, Physiotherapist Pulmonary complication are one of the most important causes of postoperative morbidity and mortality after coronary bypass surgery. Chest Physiotherapy is an important treatment modality during postoperative follow up these patient. Various different techniques are utilized to achive optimal hygiene. The ideal postural drainage position should acomplish this without compromising the hemodynamic status of the patient.“Bed Flat”position is a comfortable postural dreinage position from the cardiopulmonary stand point. It enables excellent pulmonary care without affecting postoperative cardiopulmonary function. It can be an alternative to the widely used“cardiac position”in post cardiac surgery chest physioyherapy. 60 patient undergoing coronary bypass surgery at the Dokuz Eylül University Medical School Department of Cardiothoracic Surgery between 1995-1996 randomly devided in 2 groups for a prospective study to evaluate the pulmonary and hemodynamic effects of these two different positions. The cardiac position (45-60 degree upright sitting) group had a mean age of 55. 16 ± 9.56 (42-75) and the bed flat position group (lying flat on back) had a mean age of 57.50 ± 9.50 (36-71) ( p>0.05). Both groups were similar in regards to sex, physical characteristics, risk factors, medical history and diagnostic evaluation test results. Bed flat and Cardiac position chest physiotherapy was given to the two seperate groups of 30 patients in the intensive care unit, during early postoperative recovery. Chest physiotherapy session. The results were compared using appropriate statictical metods. There was no statistically significant difference between the two groups in the pre - physiotherapy evalutiorr of the first session in regards to Cardiac Index (CI), Heart Rate (HR), mean Pulmonary artery pressure (mPAP), Sistolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) ( p>0.05). After the first session of physiotherapy the CI, mPAP, SBP and DBP values were lower in the bed flat positon group. But the only statistically significant difference was observed in the mPAP of the bed flat group (p<0.05). Like wise the fall in mPAP of the bed flat group was significantly greater after fourth session (p<0.0001). There was no significant difference between the groups in regards HR, SBP, DBP, (p>0.05). When the post therapy parameters of pH, PaCte, PaCCh and SaCfe after first and fourth session, there was no statistically significant difference (p>0.05). There was also no statistically significant difference in hospital stay duration (p>0.05). As a result, we believe bed flat position can be possible alternative to cardiac position for chest physiotherapy of cardiac surgery patient. It offers more tolerable position without decreasing the effectiveness of chest physiotherapy
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