Short-term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy.
OBJECTIVE
To study the changes in bilateral respiratory motion and pulmonary function following sternotomy and the relationships between the changes in respiratory movements, spirometry, radiographic analyses, and several intra-operative surgical characteristics.


METHODS
Respiratory motion during deep breathing and lung volumes were measured in 20 patients (mean age 65 years, SD 16) before and after median sternotomy. Chest x-rays were analyzed pre- and postoperatively and a variety of perioperative variables were measured.


RESULTS
Average abdominal motion decreased to 57% of preoperative values bilaterally 1 week postoperatively, the average lower thoracic motion decreased to 72%, and the average upper thoracic motion decreased to 87%, whereas the right upper thoracic motion increased 3% compared with preoperative values. Lung volumes decreased to around 60% of preoperative values (p<0.05). Significant correlations were found between the decrease in pulmonary function and the mean respiratory movements. Abnormal chest radiographs were found in all patients.


CONCLUSIONS
The breathing pattern before sternotomy is predominantly abdominal but moves to a thoracic and upper thoracic pattern postoperatively and is associated with reduced pulmonary function. Therapeutic interventions aimed at correcting the less effective upper thoracic breathing pattern should likely be implemented.
Ragnarsdóttir
María
M
Landspítali University Hospital, Reykjavík, Iceland. mariara@landspitali.is
KristjAnsdóttir
Asdís
A
Ingvarsdóttir
Ingveldur
I
Hannesson
Pétur
P
Torfason
Bjarni
B
Cahalin
Lawrence
L
D000005:Abdomen / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006331:Heart Diseases / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007055:Iceland; D007432:Intraoperative Period; D008168:Lung / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography; D015656:Respiratory Mechanics / Q000502:physiology*; D013147:Spirometry; D013223:Statistics as Topic; D013249:Sternum / Q000601:surgery*; D013909:Thorax / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology