CARDIOTHORACIC
SURGERY
The role of Physiotherapists – a study guide
, Perioperative Physiotherapy:
Possible post operative complications:
Atelectasis
o Up to 5% for lower abdominal surgery
o 19-59% for thoracic surgery
o Up to 88% for upper abdominal surgery
Hypoxaemia
o Can cause slow wound healing
o Supplemental oxygen required 72hrs post-surgery
o Nighttime is particularly risky (some high-risk patients may present with hypoxaemia
2-4 days after operation)
Haemodynamic instability
o AF is common in elderly people after cardiovascular surgery
o Hypovolemia - Pre/post Op Fluid restriction can cause this. (Low volume of blood)
o Arrhythmia
Chest infection
Others
o Anxiety and stress
Physical and psychological stress inhibits healing.
This can be reduced by education preoperatively and granting post
operative autonomy.
Anxiety can increase the perception of pain, compromise immunity and
promote infection.
o Fatigue
Frequent short walks may benefit these patients rather than long walks to
maintain early ambulation despite the fatigue.
o Nausea
Inhibits deep breathing
Dehydration
Electrolyte imbalance
Wound opening / bleeding
o Depression
Body image
o Urine and bowel issues
o Wound infection / sepsis
o Cognitive dysfunction
Delirium
Occurs 10-50% of patients (NICE 2010)
Can be prevented by early mob, nutrition, familiar objects
surrounding and good sleep.
o Peripheral nerve injury
o DVT (red flag)
Rationale: To minimise adverse physiological changes (post operative complications) and to facilitate
return to optimal function.
SURGERY
The role of Physiotherapists – a study guide
, Perioperative Physiotherapy:
Possible post operative complications:
Atelectasis
o Up to 5% for lower abdominal surgery
o 19-59% for thoracic surgery
o Up to 88% for upper abdominal surgery
Hypoxaemia
o Can cause slow wound healing
o Supplemental oxygen required 72hrs post-surgery
o Nighttime is particularly risky (some high-risk patients may present with hypoxaemia
2-4 days after operation)
Haemodynamic instability
o AF is common in elderly people after cardiovascular surgery
o Hypovolemia - Pre/post Op Fluid restriction can cause this. (Low volume of blood)
o Arrhythmia
Chest infection
Others
o Anxiety and stress
Physical and psychological stress inhibits healing.
This can be reduced by education preoperatively and granting post
operative autonomy.
Anxiety can increase the perception of pain, compromise immunity and
promote infection.
o Fatigue
Frequent short walks may benefit these patients rather than long walks to
maintain early ambulation despite the fatigue.
o Nausea
Inhibits deep breathing
Dehydration
Electrolyte imbalance
Wound opening / bleeding
o Depression
Body image
o Urine and bowel issues
o Wound infection / sepsis
o Cognitive dysfunction
Delirium
Occurs 10-50% of patients (NICE 2010)
Can be prevented by early mob, nutrition, familiar objects
surrounding and good sleep.
o Peripheral nerve injury
o DVT (red flag)
Rationale: To minimise adverse physiological changes (post operative complications) and to facilitate
return to optimal function.
