The Effectiveness of Deep-Breathing Exercises After Coronary Artery Bypass Surgery

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

The presence of fluid in the alveolar space could potentially cause the lung capacity to be effected as well.

The patient may have a hard time breathing because she is in pain after having surgery. Since they patient doesn’t want to breath due to the pain it can cause atelectasis and later sepsis if not treated in time. It would be important to teach the patient about splinting and to use an incentive spirometry in order to help her be able to breath. Another risk factor for the patient not being able to oxygenate would be hypovolemia since there is less blood volume which can also lead to less oxygen being able to travel in the blood or able to perfuse throughout the body.

Data: Pulmonary function testing dated 2010 showed moderately severe obstruction with positive bronchodilators response. Normal lung volumes. Evidence of air trapping. Severely reduced diffusing capacity for carbon monoxide.

I’m grateful I can get this done, but I don’t want to go recovery. On the bright side my pain will be gone and my body can make more red blood cells. This means my shortness of breath will go away and the odds of my blood vessels blocking will decrease! I’m afraid about my surgery I really am, but I’m ready, ready to feel better and live a better life. I can do more with my family, hang out with my friends, and just feel better. Dr. Williams is coming back into the room now and is telling me were about to start the procedure.

When the organs fail the only option is a transplant. With lungs there is only a 50% rate of a five year survival rate after a lung transplantation involving the end-stage respiratory disease. With such a drastic survival rate a study was completed to determine if patients could have a better outcome. This study was done to help determine effective methods to enhance lung transplants before surgery; the Doctors placed the recipients on bi-level positive airway pressure ventilation (BIPAP.) “BIPAP is a noninvasive mode of ventilation administered through a tight-fitting mask to assist spontaneously breathing patients”

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Sometimes when a patient is on the more common form of mechanical ventilation for an extended time or if the patient has undergone respiratory failure, their respiratory muscles have a tendency to become weak. With the use of this biphasic cuirass ventilation method they can have the opportunity to build and strengthen those muscles which, in return, can allow them to be weaned from the ventilator

A range of emotional factors including fear, stress, anxiety, and pain can affect a person’s ability to breathe correctly and efficiently. The healthcare environment involves a considerable amount of stress and anxiety. Patients often demonstrate fear for their own well- being or

In fact, the postoperative group experienced a successful result. The comparison of patients who had surgery prove that gains in health and physical ability persevere for several years. For example, postoperative patients’ improvements in hearing, breathing, communicating, and mental functioning exceeded the results of others. Although the postoperative group had the worst scores for breathing due to the greater necessity placed on the cardiorespiratory system, this finding is interpreted as a sign of successful treatment. (Rissanen et al., 1995). Overall, physical ability was significantly improved in the postoperative groups. Major improvements were shown for pain, sleep, and mobility. Activities of daily living (ADL) were significantly enhanced after

Another important intervention was to maintain the head of the bed at 30-45 degrees and position L.M.’s left lung into a dependent position to improve ventilation and perfusion. L.M.’s O2 was decreased to 63 and her CO2 was increased to 50. According to the IHI, it is recommended to elevate the bed to 30- 45 degrees to improve ventilation. Patients that lay in the supine position have lower spontaneous tidal volumes on pressure support ventilation compared to those laying at more of an angle (Institute for Healthcare Improvement, 2012). In regards to positioning, when the least damaged portion of the lung is placed in a dependent position it receives preferential blood flow. This redistribution of blood flow helps match ventilation and perfusion, therefore, improving gas exchange (Lough, Stacy & Urden, 2010). Implementing these interventions combined with respiratory therapy, significantly improved the blood gas values for oxygen and carbon dioxide levels.

When the subject was instructed to breath-hold after normal breathing results obtained showed a significant decrease in pO2 (p=7.11e-20) and significant increase in pCO2 (p=8.06e.-16). An increased level of carbon dioxide is called hypercarpnia. When inactive tissue isn’t in demand for oxygen, the dissociation curve as seen in figure 1 will shift to the left. Oxygen will have a high affinity for

Therefore, the overall prognosis is guarded in view of the underlying pathology, its extent and the post-operative respiratory insufficiency. The life expectancy is difficult to anticipate but the

Providing anesthesia for lung transplantation (LT) is considered by many to be a major feat in cardiothoracic anesthesia. Some say it involves the most complex manipulation of cardiothoracic physiology, especially when cardiopulmonary bypass (CPB) is not used. There are many indications for end-stage pulmonary disease, from obstructive lung disease to pulmonary vascular disease. Traditionally, ventilation strategies for this population included tidal volumes of 8-12ml/kg to prevent atelectasis and zero PEEP to prevent a shunt of blood flow (Slinger, 2012). This strategy proved to cause harm during the periorperative period. Research now indicates that a reduction in tidal volume with added PEEP not only decreases atelectasis, but it also reduces pulmonary inflammatory response (Coppola, Froio, & Chuimello 2014). These patients already have a decreased respiratory reserve, therefore inducing an inflammatory mediated response with ventilation settings can be detrimental and should be avoided at all costs by the nurse anesthetist. It is imperative for the nurse anesthetist understand the necessity of lung protective ventilation strategies in LT.

For some patients with COPD medications, pulmonary rehabilitation and other typical interventions may not be enough. Particularly for patients with later stage COPD, surgery may be the best option .