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Inspiratory Muscle Weakness is Related to Poor Short-Term Outcomes for Heart Transplantation.

Authors
  • Begot, Isis1
  • Gomes, Walter J1, 2
  • Rocco, Isadora S1
  • Bublitz, Caroline1, 2
  • Gonzaga, Laion R A1
  • Bolzan, Douglas W1
  • Santos, Vinicius Batista3
  • Moreira, Rita Simone Lopes3
  • Breda, João R1
  • Almeida, Dirceu Rodrigues de1
  • Arena, Ross4
  • Guizilini, Solange5
  • 1 Cardiology Postgraduate Program, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil. , (Brazil)
  • 2 Cardiology and Cardiovascular Surgery Disciplines, Sao Paulo Hospital, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil. , (Brazil)
  • 3 Paulista School of Nursing, Federal University of Sao Paulo, Sao Paulo, Brazil. , (Brazil)
  • 4 Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States of America. , (United States)
  • 5 Department of Human Motion Sciences, Federal University of Sao Paulo, São Paulo, Brazil. , (Brazil)
Type
Published Article
Journal
Brazilian journal of cardiovascular surgery
Publication Date
Jun 01, 2021
Volume
36
Issue
3
Pages
308–317
Identifiers
DOI: 10.21470/1678-9741-2020-0344
PMID: 33438847
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In heart transplantation (HT) recipients, several factors are critical to promptly adopting appropriate rehabilitation strategies and may be important to predict outcomes way after surgery. This study aimed to determine preoperative patient-related risk factors that could adversely affect the postoperative clinical course of patients undergoing HT. Twenty-one hospitalized patients with heart failure undergoing HT were evaluated according to respiratory muscle strength and functional capacity before HT. Mechanical ventilation (MV) time, reintubation rate, and intensive care unit (ICU) length of stay were recorded, and assessed postoperatively. Inspiratory muscle strength as absolute and percentpredicted values were strongly correlated with MV time (r=-0.61 and r=-0.70, respectively, at P<0.001). Concerning ICU length of stay, only maximal inspiratory pressure (MIP) absolute and percent-predicted values were significantly associated. The absolute |MIP| was significantly negatively correlated with ICU length of stay (r=-0.58 at P=0.006) and the percent-predicted MIP was also significantly negatively correlated with ICU length of stay (r=-0.68 at P=0.0007). No associations were observed between preoperative functional capacity, age, sex, and clinical characteristics and MV time and ICU length of stay in the cohort included in this study. Patients with respiratory muscle weakness had a higher prevalence of prolonged MV, reintubation, and delayed ICU length of stay. An impairment of preoperative MIP was associated with poorer short-term outcomes following HT. As such, inspiratory muscle strength is an important clinical preoperative marker in patients undergoing HT.

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