Kalp Cerrahisi Sonrası Kardiyak Rehabilitasyon

Yazarlar

Özet

Kardiyovasküler rehabilitasyon, klinik stabilizasyon elde etmeyi, kardiyovasküler hastalığın fizyolojik ve psikolojik etkilerini sınırlamayı, semptomları yönetmeyi ve kalp krizi riskini azaltmayı amaçlayan, yeterli eğitime sahip sağlık profesyonelleri tarafından denetlenen ve yürütülen, ikincil korunmada çok faktörlü ve kapsamlı bir müdahaledir. Kalp damar cerrahisi sonrası uygulanan rehabilitasyon programının miyokardiyal revaskülarizasyonu artırdığı, kardiyak semptomları azalttığı, kas iskelet sistemi üzerinde gelişme sağladığı, hastanede yatış gününü kısalttığı ve yaşam kalitesini artırdığı bildirilmektedir. Önerilen rehabilitasyon programında; hastalarda kardiyovasküler direnci arttırmak için egzersizler haftada en az 3 seans olacak şeklide planlamalı ve uygun şartlarda 5 seansa kadar çıkılabilmelidir. Hastane döneminde haftada 5-6 kez, taburculuk sonrasında haftada 2-3 kez olmalıdır.

 

Cardiovascular rehabilitation is a multifaceted and comprehensive intervention in secondary prevention. It is supervised and conducted by adequately trained health professionals with the objective of achieving clinical stabilization, limiting the physiological and psychological effects of cardiovascular disease, managing symptoms, and reducing the risk of heart attack. A rehabilitation program following cardiovascular surgery has been demonstrated to enhance myocardial revascularization, alleviate cardiac symptoms, optimize the musculoskeletal system, reduce hospitalization days, and elevate quality of life. The recommended rehabilitation program entails the incorporation of exercises into at least three sessions per week, with the potential for an increase to five sessions under suitable circumstances. This regimen should be maintained at a frequency of five to six times per week during hospitalization and two to three times per week following discharge.

Referanslar

Beatty AL, Bradley SM, Maynard C, McCabe JM. Referral to cardiac rehabilitation after percutaneous coronary intervention, coronary artery bypass surgery, and valve surgery: data from the clinical outcomes assessment program. Circulation: Cardiovascular Quality and Outcomes,2017, Volume 10, Number 6 https://doi.org/10.1161/.

Pack QR, Goel K, Lahr BD, et al. Participation in cardiac rehabilitation and survival after coronary artery bypass graft surgery: a community-based study. Circulation. 2013;128:p: 590–597.

Ma L, Deng L, Yu H. The effects of a comprehensive rehabilitation and intensive education program on anxiety, depression, quality of life, and major adverse cardiac and cerebrovascular events in unprotected left main coronary artery disease patients who underwent coronary artery bypass grafting. Ir J Med Sci 2020;(189):477–88.

American Association of Cardiovascular & Pulmonary Rehabilitation. Guidelines for Cardiac Rehabilitation Programs, 6th ed. Champaign, IL: Human Kinetics; 2021, p:33-47

Dibben GO, Faulkner J, Oldridge N et al. Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis, European Heart Journal, Volume 44, Issue 6, 7 February 2023, Pages 452–469.

Anderson L, Thompson DR, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2016.

Taylor T,. Dalal HM, Sinéad T. J. McDonagh, The role of cardiac rehabilitation in improving cardiovascular outcomes, Cardıology, 2022, 19: 180-194.

Beatty LA , MAS MD; Becki TM et al, A new era in cardiac rehabilitation delivery: research gaps, questions, strategies, and priorities, Circulation. 2023;147:254–266.

Salzwedel A, Jensen K, Rauch B. et al. Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: update of the cardiac rehabilitation outcome study (CROS-II). Eur J Prev Cardiology 2020;27:1756–1774.

He C-J, Zhu C-Y, Zhu Y-J, et al. Effect of exercise-based cardiac rehabilitation on clinical outcomes in patients with myocardial infarction in the absence of obstructive coronary artery disease (MINOCA). Int J Cardiol 2020;315:9–14.

Powell R, McGregor G, Ennis S, et al. Is exercise-based cardiac rehabilitation effective? A systematic review and meta-analysis to re-examine the evidence. BMJ Open 2018;8.

Aronov D, Bubnova M, Iosseliani D, Orekhov A. Clinical efficacy of а medical centre- and home-based cardiac rehabilitation program for patients with coronary heart disease after coronary bypass graft surgery. Arch Med Res 2019;50:122–32.

Eskiyecek G, Türken A, Kardiyak Rehabilitasyon ve Egzersiz, Egzersiz Spor ve Sağlık Edit. Zeynep Filizi Dinç, Sonçağ Matbaacılı,k Ankara, 2020,sf:41-53.

Standards and Core Components, The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2023 (4th edition),British Association for Cardiovascular Prevention and Rehabilitation, https://www.bacpr.org data/assets/pdf_file/0021/64236/BACPR-Standards-and-Core-Components-2023.pdf (Erişim tarihi: 08.09.2023)

National Institute for Health and Care Excellence (2019) NICE guideline (NG 136): Hypertension in adults: diagnosis and management. Available at: https://www.nice.org.uk/guidance/ng136 (Erişim tarihi: 03.09.2023)

Scottish Intercollegiate Guidelines Network (2018) SIGN 152: Cardiac arrhythmias in coronary heart disease. Available at: https://www.sign.ac.uk/media/1089/sign152.pdf (Erişim tarihi: 08.09.2023)

National Institute for Health and Care Excellence (2010) NICE guideline (NG 28): Type 2 diabetes in adults: management. Available at: https://www.nice.org.uk/guidance/ng28 (Erişim tarihi: 30.08.2023)

Scottish Intercollegiate Guidelines Network (2017) SIGN 154: Pharmacological management of glycaemic control in people with type 2 diabetes. A national clinical guideline. Available at: https://www.sign.ac.uk/media/1090/sign154.pdf (Erişim tarihi: 01.09.2023)

Abreu A, Frederix I, Dendale P, et al. Secondary Prevention and Rehabilitation Section of EAPC Reviewers:. Standardization and quality improvement of secondary prevention through cardiovascular rehabilitation programmes in Europe: The avenue towards EAPC accreditation programme: A position statement of the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol. 2021 May 14;28(5):496-509.

Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol. 2021 May 14;28(5):460-495.

Japanese Circulation Society Joint Working Group (2014) Guidelines for rehabilitation in patients with cardiovascular disease. Circulation 78 2022 – 2093 (Erişim tarihi: 029.08.2023)

Purcell C, Daw P, Kerr C, et al. Protocol for an implementation study of an evidence-based home cardiac rehabilitation programme for people with heart failure and their caregivers in Scotland (SCOT:REACH-HF). BMJ Open. 2020 Dec 4;10(12):e040771.

Daw P, van Beurden SB, Greaves C et al. Getting evidence into clinical practice: protocol for evaluation of the implementation of a home-based cardiac rehabilitation programme for patients with heart failure. BMJ Open. 2021 Mar 12;11(3). doi: 10.1136/bmjopen-2019-036137.

Sheng, S., Feinberg, J., Bostrom, J.et al. (Adherence and exercise capacity improvements of patients with adult congenital heart disease participating in cardiac rehabilitation. Journal of the American Heart Association 2022:11

Vrati M M, Diann E Gaalema, Maureen P. et el. Systematic review of cardiac rehabilitation guidelines: Quality and scope, European Journal of Preventive Cardiology, Volume 27, Issue 9, 1 June 2020, P: 912–928.

Frank L J Visseren, François Mach, Yvo M Smulders, et al. ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC), European Heart Journal, Volume 42, Issue 34, 7 September 2021, Pages 3227–3337,

Uddin, J. et al. Effect of home-based cardiac rehabilitation in a lower-middle income country: results from a controlled trial. J. Cardiopulm. Rehabilitation Prev. (2020). 40, 29–34

Taylor, R. S. & Singh, S. Personalised rehabilitation for cardiac and pulmonary patients with multimorbidity: time for implementation? Eur. J. Prev. Cardiol. 2020 https:// doi.org/10.1177/2047487320926058

Xue W, Xinlan Z, Xiaoyan Z. Effectiveness of early cardiac rehabilitation in patients with heart valve surgery: a randomized, controlled trial. J Int Med Res. 2022 Jul;50 (7).

Arıkan H. Kardiyak Rehabilitasyonun Evreleri. Turkiye Klinikleri Journal of Cardiology Special Topics. 2012;5(2):64-8.

31.National Institute for Health and Care Excellence (2013) BMI: preventing ill health and premature death in black, Asian and other minority ethnic groups. Public health guideline [PH46] Available at: https://www.nice.org.uk/guidance/ph46/ (Erişim tarihi: 07.09.2023)

Butler, T., Kerley,C., Altieri, N., Alvarez, J., Green, J., Hinchliffe. J, et al. (2020) Optimum nutritional strategies for cardiovascular isease prevention and rehabilitation (BACPR). Heart 106 (10) 724-31.

Uzun M. Kardiyak rehabilitasyonda hasta eğitimi ve egzersiz, Anadolu Kardiyoloji Dergisi, 2007; 7: 298-304.

Rengin D. Kardiyak Rehabilitasyonda Egzersiz. Türkiye Klinikleri Dergisi, 2012 (CardiolSpecial topics 5):47-51

Association of Chartered Physiotherapists in Cardiac Rehabilitation (2015) Standards for physical activity and exercise in the cardiovascular population. Available at: ACPICRStandards.pdf (Erişim tarihi: 01.09.2023)

Department of Health & Social Care (2019) UK Chief Medical Officers’ Physical Activity Guidelines. Available: Physical activity guidelines: UK Chief Medical Officers’ report - GOV.UK (www.gov.uk) (Erişim tarihi: 08.09.2023)

Cossette, S., Frasure-Smith, N., Dupuis, J. et el. Randomized controlled trial of tailored nursing interventions to improve cardiac rehabilitation enrolment. Nursing Research 2021, V 261 (2) 111 – 20

Wingham, J., Frost, J., Britten, N et al. Caregiver outcomes of the REACHHF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction. European Journal of Cardiovascular Nursing, 2019, 18 611 – 20.

Gelecek

23 Ocak 2025

Lisans

Lisans