Re: pre- and postcardiopulmonary rehabilitation in hospitalized patients undergoing coronary artery bypass surgery: a randomized control trial.

摘要

To the Editor: Herdy et al. studied the effect of an in-hospital cardiopulmonary rehabilitation program, which was completed before and after a coronary artery bypass graft (CABG), on the postoperative outcomes. The study focused on patients awaiting the CABG surgery and their exposure to potential risks from immobilization.1 The cardiopulmonary rehabilitation program was administered randomly to 29 patients (rehabilitation group), 5 days before surgery and extended through discharge, and 27 patients (the control group) only received the program postoperatively. The hopes were that the preoperative, cardiopulmonary rehabilitation program would decrease the duration of hospital stay and reduce postoperative complications. The study results focused on time until endotracheal extubation, incidence of pleural effusion, atelectasis, pneumonia, atrial fibrillation or flutter, and duration of postoperative in-hospital stay. The results indicated significant reduction of pneumonia, atrial fibrillation, and duration of hospital stay in the ward; however, the duration of stay in the intensive care unit was not significant secondary to the rehabilitation. There was a decrease in orotracheal intubation, fewer pleural effusions, and atelectasis than in the control group. However, the rehabilitation group exhibited a significant reduction in the peak flow and covered a greater distance during the 6-min walk test. The study concluded, "... pre- and postoperative cardiopulmonary rehabilitation program reduces the incidence of complications, reduces hospital stay, and may partially preserve functional capacity after CABG."