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Critical Care Research and Practice
Volume 2012 (2012), Article ID 291628, 7 pages
http://dx.doi.org/10.1155/2012/291628
Clinical Study

Lung Function before and Two Days after Open-Heart Surgery

1Physiotherapy, Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden
2School of Health and Medical Sciences, Örebro University, 701 82 Örebro, Sweden
3Clinical Physiology, Department of Medical Sciences, Uppsala University, 751 05 Uppsala, Sweden
4Respiratory Medicine and Allergology, Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden

Received 23 March 2012; Revised 14 June 2012; Accepted 17 June 2012

Academic Editor: Samuel A. Tisherman

Copyright © 2012 Charlotte Urell et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n=107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC) (33±14% pred.) than normal-weight patients (39±15% pred.), (P=0.04). More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r=0.33, P=0.001; FEV1: r=0.35, P0.0001; IC: r=0.25, P=0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.