The goal of this observational and prospective study is to investigate changes in physical performance, lung function, and respiratory and peripheral muscle strength in patients during the postoperative period following coronary artery bypass grafting (CABG) and valve replacement surgery..
This study aims to investigate the physical changes in patients undergoing myocardial revascularization surgery and valve replacement. It will observe alterations in physical performance, lung function, and muscle strength during the postoperative period. The study, observational and prospective, will include individuals aged ≥18 scheduled for these surgeries, evaluating them preoperatively, post-intensive care unit discharge, and before hospital discharge. Assessments involve tests like the Short Physical Performance Battery, 1-minute sit-to-stand test, Clinical Frailty Scale, manovacuometry, dynamometry, and spirometry to identify frailty and measure muscle and lung function. The study also aims to explore predictive variables for functional loss and mortality during hospitalization.
Study Type
OBSERVATIONAL
Enrollment
200
Instituto do Coração - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
São Paulo, São Paulo, Brazil
RECRUITINGTo investigate changes in physical performance measured by Short Physical Performance Battery (SPPB)
Measures: walking speed, standing balance and sit-to-stand performance.
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate changes in physical performance measured by Six-Minute Walk Test.
Measures: the assessment will take place in a flat 30-meter corridor, marked every 1 meter with non-slip flooring, and the patient will be instructed to walk for six minutes as fast as possible.
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate changes in physical performance by 1-minute sit-to-stand test (1-MSTST)
Measure: number of 1-MSTST repetitions.
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate changes in peripheral muscle strength
Measure: hand grip strengh measure (Kgf)
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate changes in respiratory muscle strength:
Measures: maximal inspiratory and expiratory pressure (cmH2O)
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate changes in lung function test measure by spirometry:
Measures: FVC (L), FEV1 (L), FEF (L/s) and FEF 25-75 (%)
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Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To investigate frailty by Clinical Frailty Scale (CFS)
The minimal value is 1 and the maximal is 9 in which the lowest scores mean worse outcomes.
Time frame: Baseline (one day before the surgery), after the surgery (the day immediately after ICU discharge) and through study completion, an average of 15 days.
To explore potential preoperative and immediate postoperative risk factors as predictors of functional loss.
Occurrence of comorbidities and clinical variables associated with functional decline
Time frame: Baseline (one day before the surgery) during the immediate postoperative period.
To investigate hemodynamic behavior during the Short Physical Performance Battery (SPPB).
Measures: heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure.
Time frame: Immediately before and after the SPPB.
To investigate hemodynamic behavior during the 1-minute sit-to-stand test (1-MSTST).
Measures: heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure.
Time frame: Immediately before and after the 1-MSTST tests.
To investigate respiratory behavior during the Short Physical Performance Battery (SPPB).
Measures: respiratory rate, Borg dyspnea scale and peripheral oxygen saturation.
Time frame: Immediately before and after the SPPB.
To investigate respiratory behavior during 1-minute sit-to-stand test (1-1-MSTST).
Measures: respiratory rate, Borg dyspnea scale and peripheral oxygen saturation.
Time frame: Immediately before and after the 1-MSTST tests.