Spirometric values and chest pain intensity three days post-operative coronary artery bypass graft surgery

Coronary artery bypass graft surgery [CABG] is proved to have ventilatory complications and reduction in Spirometric values. This study aimed to examine the hypothesis that reduction of post-operative chest pain intensity would be associated with improvement in the Spirometric values for patient underwent CABG. 26 cardiac patients recruited for this study. Their convenience to the study inclusion criteria decided their eligibility. Through 3 days after elective CABG their Spirometric values were measured along with their perception to chest pain intensity using 0-10 numeric rating scale. Collected data were recorded and analyzed statistically. Chest pain intensity showed progressive significant [P = 0.0001] reduction through the 3 days post-operative. On the other hand Spirometric values also showed progressive improvement through the 3 days post-operative. This improvement was significant for all measured spirometric values except for the ratio of forced expiratory volume in the 1st second to the forced vital capacity [P = 0.134]. There was no significant relationship between the chest pain intensity and spirometric values. This was applied to all measured Spirometric values and to the 3 days postoperative. The current study findings rejected the examined hypothesis that reduction of post-operative chest pain intensity would be associated with improvement in the spirometric values for patient underwent coronary artery bypass graft surgery. There was no significant relationship between the chest pain intensity and any of the spirometric values at any of the 3 post-operative days

Assessment of pulmonary function tests in cardiac patients

This study was aimed to assess the pulmonary function tests [PFTs] in cardiac patients; with ischemic or rheumatic heart diseases as well as in patients who underwent coronary artery bypass graft [CABG] or valvular procedures. For the forty eligible participants, the pulmonary function was measured using the spirometry test before and after the cardiac surgery. Data collection sheet was used for the patient's demographic and intra-operative information. Cardiac diseases and surgeries had restrictive negative impact on PFTs. Before surgery, vital capacity [VC], forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], ratio between FEV1 and FVC, and maximum voluntary ventilation [MVV] recorded lower values for rheumatic patients than ischemic patients [P values were 0.01, 0.005, 0.0001, 0.031, and 0.035, respectively]. Moreover, patients who underwent valvular surgery had lower PFTs than patients who underwent CABG with significant differences for VC, FVC, FEV1, and MVV tests [P values were 0.043, 0.011, 0.040, and 0.020, respectively]. No definite causative factor appeared to be responsible for those results although mechanical deficiency and incisional chest pain caused by cardiac surgery are doubtful. More comprehensive investigation is required to resolve the case

Can lung volumes and capacities be used as an outcome measure for phrenic nerve recovery after cardiac surgeries?

Phrenic nerve is the main nerve drive to the diaphragm and its injury is a well-known complication following cardiac surgeries. It results in diaphragmatic dysfunction with reduction in lung volumes and capacities. This study aimed to evaluate the objectivity of lung volumes and capacities as an outcome measure for the prognosis of phrenic nerve recovery after cardiac surgeries. In this prospective experimental study, patients were recruited from Cardio-Thoracic Surgery Department, Educational Hospital of College of Medicine, Cairo University. They were 11 patients with right phrenic nerve injury and 14 patients with left injury. On the basis of receiving low-level laser irradiation, they were divided into irradiated group and non-irradiated group. Measures of phrenic nerve latency, lung volumes and capacities were taken pre and post-operative and at 3-months follow up. After 3 months of low-level laser therapy, the irradiated group showed marked improvement in the phrenic nerve recovery. On the other hand, vital capacity and forced expiratory volume in the first second were the only lung capacity and volume that showed improvement consequent with the recovery of right phrenic nerve [P value <0.001 for both]. Furthermore, forced vital capacity was the single lung capacity that showed significant statistical improvement in patients with recovered left phrenic nerve injury [P value <0.001]. Study concluded that lung volumes and capacities cannot be used as an objective outcome measure for recovery of phrenic nerve injury after cardiac surgeries