OBJECTIVE: To study the changes in bilateral respiratory motion and pulmonary function following sternotomy and the relationships between the changes in respiratory movements, spirometry, radiographic analyses, and several intra-operative surgical characteristics. DESIGN: Respiratory motion during deep breathing and lung volumes were measured in 20 patients (mean age 65 years, SD 16) before and after median sternotomy. Chest x-rays were analyzed pre- and postoperatively and a variety of perioperative variables were measured. RESULTS: Average abdominal motion decreased to 57% of preoperative values bilaterally 1 week postoperatively, the average lower thoracic motion decreased to 72%, and the average upper thoracic motion decreased to 87%, whereas the right upper thoracic motion increased 3% compared with preoperative values. Lung volumes decreased to around 60% of preoperative values (p<0.05). Significant correlations were found between the decrease in pulmonary function and the mean respiratory movements. Abnormal chest radiographs were found in all patients. CONCLUSION: The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented.
OBJECTIVE: To study the changes in bilateral respiratory motion and pulmonary function following sternotomy and the relationships between the changes in respiratory movements, spirometry, radiographic analyses, and several intra-operative surgical characteristics. DESIGN: Respiratory motion during deep breathing and lung volumes were measured in 20 patients (mean age 65 years, SD 16) before and after median sternotomy. Chest x-rays were analyzed pre- and postoperatively and a variety of perioperative variables were measured. RESULTS: Average abdominal motion decreased to 57% of preoperative values bilaterally 1 week postoperatively, the average lower thoracic motion decreased to 72%, and the average upper thoracic motion decreased to 87%, whereas the right upper thoracic motion increased 3% compared with preoperative values. Lung volumes decreased to around 60% of preoperative values (p<0.05). Significant correlations were found between the decrease in pulmonary function and the mean respiratory movements. Abnormal chest radiographs were found in all patients. CONCLUSION: The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented.
Authors: Steven C Koenig; Jorge H Jimenez; Seth D West; Michael A Sobieski; Young Choi; Gretel Monreal; Guruprasad A Giridharan; Kevin G Soucy; Mark S Slaughter Journal: ASAIO J Date: 2014 Nov-Dec Impact factor: 2.872
Authors: Orlando Santana; Steve Xydas; Roy F Williams; Maurice Mawad; Todd B Heimowitz; Andrés M Pineda; Howard S Goldman; Christos G Mihos Journal: J Thorac Dis Date: 2017-06 Impact factor: 2.895