Effects of Early Mobilization on Hemodynamics and Pain after Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial.

Journal of caring sciences Pub Date : 2024-08-06 eCollection Date: 2025-02-01 DOI:10.34172/jcs.025.33510
Sevda Jalili, Atefeh Allahbakhshian, Azizeh Farshbaf Khalili, Khorshid Mobasseri
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Abstract

Introduction: Patients with coronary artery disease (CAD) can improve quality of life by undergoing coronary artery bypass graft (CABG), but they may face various complications. Early mobilization can help prevent these complications. This study aimed to evaluate the effects of two early mobilization protocols on pain and hemodynamic outcomes in patients who had CABG surgery.

Methods: This was a randomized, blinded clinical trial with a three-arm parallel design, conducted on 105 patients who underwent CABG at Shahid Madani hospital in Tabriz. The patients were randomly assigned to three groups: control, first intervention, and second intervention. The control group received standard care, while two intervention groups received early mobilization based on passive and active range of motion (ROM) activities and early mobilization based on deep breathing exercises respectively. Data were collected using a questionnaire that measured pain intensity using a facial pain scale and hemodynamic indicators using a monitor device. Data analysis was performed using SPSS version 24 software and descriptive and inferential statistics methods.

Results: According to the study, the second intervention group is more effective than the first intervention group. The results indicated that in both morning and evening shifts, the mean of systolic blood pressure (SBP) increased significantly in three groups. Also, the mean of diastolic blood pressure (DBP) increased significantly in both shifts in intervention group 1 and control. The mean of DBP decreased (MD=-26.0, 95% CI: -5.6 to -1.2; P=0.003) significantly among intervention group 2 compared to control group in the evening. The results also indicated that the mean of heart rate (HR) raised significantly in both shifts in all three groups. In the morning, there was a significant difference between intervention group 2 and 1 compared to control. The mean of arterial oxygen saturation was a significant difference between intervention group 2 and intervention group 1 and control group in the both shifts. The mean of pain decreased significantly in the morning in two intervention groups. Similarly, in the evening, the mean of pain decreased significantly in intervention group 1, and intervention group 2. Both in the morning and evening, there was a significant difference between intervention group 2 and intervention group 1 (P<0.001).

Conclusion: This study provides valuable insights into the effects of early mobilization interventions on patients after CABG, but more research is needed to determine the optimal timing and intensity of mobilization protocols for patients after CABG and to explore the long-term effects and cost-effectiveness of these interventions.

早期运动对冠状动脉搭桥术后血流动力学和疼痛的影响:一项随机对照试验。
导语:冠心病(CAD)患者可以通过行冠状动脉旁路移植术(CABG)改善生活质量,但可能面临各种并发症。早期活动有助于预防这些并发症。本研究旨在评估两种早期活动方案对CABG手术患者疼痛和血流动力学结果的影响。方法:这是一项随机、盲法临床试验,采用三臂平行设计,在大不里士的Shahid Madani医院进行了105例CABG患者。患者被随机分为三组:对照组、第一次干预组和第二次干预组。对照组接受标准护理,而两个干预组分别接受基于被动和主动活动范围(ROM)活动的早期活动和基于深呼吸练习的早期活动。数据通过问卷收集,问卷使用面部疼痛量表测量疼痛强度,使用监测装置测量血流动力学指标。数据分析采用SPSS 24版软件,采用描述统计和推理统计方法。结果:根据研究,第二次干预组比第一次干预组更有效。结果显示,在早晚两班,三组患者的平均收缩压(SBP)均显著升高。此外,干预组1和对照组的平均舒张压(DBP)在两组轮班中均显著升高。平均DBP下降(MD=-26.0, 95% CI: -5.6 ~ -1.2;P=0.003)。结果还表明,在所有三组的两个班次中,平均心率(HR)都显着升高。在早上,干预组2和干预组1与对照组相比有显著差异。干预组2与干预组1及对照组的动脉血氧饱和度均值均有显著性差异。两组患者上午疼痛均值均明显降低。同样,在晚上,干预组1和干预组2的平均疼痛明显降低。在早上和晚上,干预组2和干预组1之间都有显著差异(p结论:本研究为CABG后早期活动干预对患者的影响提供了有价值的见解,但需要更多的研究来确定CABG后患者活动方案的最佳时间和强度,并探讨这些干预措施的长期效果和成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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