Abstract

Aim. The aim of this study was to examine the effect of early mobilization on hemodynamic parameters in patients undergoing coronary artery bypass graft (CABG) surgery.

Background. CABG is one of the most common surgeries that can increase quality of life and reduce mortality in most cases. It seems that early mobilization of patients from bed may reduce complications after surgery. The most important concern regarding early mobilization is the possible effect on hemodynamic parameters based on which this important intervention is neglected.

Method. In a clinical trial with 100 patients who were candidate for CABG. The patients were randomly assigned to experimental and control group. The experimental group were mobilized from bed in the first, second and third day after surgery. The control group received the hospital routine treatments and mobilization was done in the third day after the operation. The effect of early mobilization on hemodynamic parameters were compare between the groups. Other treatment programs were the same for both group. Data were analyzed in SPSS version 18 and using independent t-test, Chi-square and ANOVA statistical testes.

Findings. There was no statistically significant difference between groups regarding demographic variables and underlying diseases. In the experimental group, blood pressure was higher in the second and third days  compared with that control group. Chest tube drainage on the third day were 495±241 ml for experimental group and 556±285 ml for the control group, and no statistically significant difference was found between the groups in terms of chest tube drainage. None of the patients showed any complication during the mobilization.

Conclusion. The experimental group experienced a minimal increase in blood pressure, but it was not clinically significant. The results of this study indicate that early mobilization from bed in patients undergoing coronary artery bypass graft is a safe and applicable intervention, and don’t increase bleeding and acute hemodynamic changes.

Abstract

Aim. The present study was conducted with the aim of investigating the incidence of complications after cardiac surgery in the period from the patient's admission to the ward to three days thereafter at Jamaran Heart Hospital in 2022-2023.

Background. Regarding the selected and proposed treatments for cardiovascular diseases, every year a large number of patients undergo heart and coronary artery bypass graft surgery and valve repair or replacement. According to the surgical procedure, there are many cardiac and non-cardiac complications for these patients. 

Method. The present study was a cross-sectional descriptive study that was conducted between 2022 and 2023 in Jamaran Heart Hospital in Tehran, Iran. In this study, 254 patients who were candidates for heart surgery were recruited using convenience sampling method. Data were collected using demographic characteristics form, checklist for short-term complications after open heart surgery, and numerical pain scale. The time period of data collection was from the moment the patient entered the intensive care unit to the time of transfer to the ward (three days). The data were analyzed in SPSS version 22 using descriptive statistics.

Findings. Most of patients underwent valve surgery or combined valve and coronary artery graft surgery (68.1 percent). Most of patients were male (62.3 percent), and had a history of high blood pressure (60.5 percent). The mean of age and ejection fraction at discharge was 60.4 years and 48.4 percent, respectively. On the third day after surgery, the incidence of complications was as follows: atelectasis, 18.9 percent; pleural effusion, 15 percent; and pneumothorax, 2.8 percent. The highest average pain score was 3.74 when using incentive spirometry and 4.54 when coughing. Regarding arrhythmia, the highest rate was related to sinus tachycardia (12.6 percent) and atrial fibrillation (9.6 percent).

Conclusion. Goal-directed planning is necessary to manage complications after open heart surgery. Conducting more studies with the aim of investigating etiology and appropriate management of risk factors is also suggested.