Assuntos
Acidentes de Trabalho/psicologia , Adaptação Psicológica , Agricultura , Amputados/psicologia , Traumatismos do Antebraço/cirurgia , Traumatismos da Mão/cirurgia , Transplante de Mão/psicologia , Atividades Cotidianas/psicologia , Adulto , Amputados/reabilitação , Traumatismos do Antebraço/psicologia , Rejeição de Enxerto/psicologia , Rejeição de Enxerto/reabilitação , Traumatismos da Mão/psicologia , Traumatismos da Mão/reabilitação , Força da Mão , Transplante de Mão/reabilitação , Humanos , Masculino , Terapia Ocupacional/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Reabilitação Vocacional/psicologiaRESUMO
Although cross-sectional late-phase reinnervation in heart transplantation (HTx) recipients has been demonstrated by several earlier studies, early-phase successive analyses especially for parasympathetic reinnervation remain unknown. Successive heart rate variability (HRV) data calculated by the MemCalc power spectral density method were obtained from 16 non-rejection recipients 1-24 weeks after HTx. High frequency (HF) level representing parasympathetic magnitude increased significantly at 6 months after HTx (from 0.9 ± 0.7 to 4.1 ± 2.8 ms(2*)). Only intraoperative shorter cardiopulmonary bypass time (181 ± 59 minutes) correlated with a higher level of HF at post-HTx 6 months among all baseline variables (r = -0.530(*)). Higher level of HF was associated with recovery of tachycardia at post-HTx 6 months (r = -0.514(*)). In conclusion, parasympathetic reinnervation emerges along with recovery of tachycardia < 6 months after HTx, which is accelerated by shorter intraoperative cardiopulmonary bypass time ((*)P < 0.05 for all).
Assuntos
Ponte Cardiopulmonar/métodos , Rejeição de Enxerto/reabilitação , Transplante de Coração/reabilitação , Coração/inervação , Regeneração Nervosa/fisiologia , Sistema Nervoso Parassimpático/fisiologia , Adulto , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Humanos , Masculino , Período Pós-Operatório , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de TempoRESUMO
Late graft outcome depends on an intensive post-transplant care program. Direct post-transplant inpatient rehabilitation in a specialized hospital as well as outpatient services, along with an inpatient check-up every 2-3 years are important for maintaining an excellent long-term graft function. In our experience recognizing and treating risk factors after organ transplantation such as arterial hypertension, vasculopathy, hyperlipidemia, metabolic syndrome including PTDM, osteoporosis, recurrent diseases and also the recipient's education (compliance) are most important landmarks in a post-transplant care program. This inpatient as well as outpatient post-transplant care program with the aim of long-term graft function for organ recipients, performed in a network, represents a modern health service including effective and economical aspects, which health insurance in Germany is obliged to pay for.
Assuntos
Rejeição de Enxerto/epidemiologia , Rejeição de Enxerto/reabilitação , Pacientes Internados/estatística & dados numéricos , Transplante de Rim/reabilitação , Transplante de Rim/estatística & dados numéricos , Cuidados Pós-Operatórios/estatística & dados numéricos , Alemanha , Rejeição de Enxerto/prevenção & controle , Humanos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricosRESUMO
Cardiac transplantation should not only enlarge life time but additionally should provide the patient with good quality of life and a satisfactory rehabilitation level. An integrated rehabilitation program can help to the process of recovery. In spite of the multiple factors which modify the physiological response during exercise, an appropriate training can be reached by many patients. Nevertheless the physiological rehabilitation is one of the components of the patients global restitution in order to reach satisfactory life style after transplantation.
