The effects of sternotomy and thoracotomy on respiratory muscle strength

Abstract

Objective: The aim of this prospective clinical study was to investigate the effects of sternotomy and thoracotomy on respiratory muscle strength (RMS). Method: After obtaining ethics committee approval and written informed consent from patients, 60 patients who underwent open heart surgery using sternotomy (Sternotomy Group [SG], n=30) or lung surgery using thoracotomy (Thoracotomy Group [TG], n=30) were included. Pulmonary function test (PFT) and respiratory muscle strength (RMS) test were performed before and after surgery to compare forced expiratory volume during the first second of the breath (FEV1), forced vital capacity (FVC), maximal inspiratory pressure (Pİmax), maximal expiratory pressure (PEmax), and sniff nasal inspiratory pressure (SNIP) between groups. Results: Preoperative FEV1, FVC, Pİmax, PEmax, and SNIP were similar between groups (p>0.05) and were found to be decreased significantly in the postoperative period (p<0.001). Postoperative FVC was significantly lower in SG than TG (p=0.021). The rates of decrease in FVC and Pİmax were significantly higher in SG than TG (48.71% vs. 34.95% for FVC; p=0.04 and 38.38% vs. %32.8 for Pİmax; p=0.04). Conclusion: It is concluded that pulmonary functions and respiratory muscle strength may decrease after sternotomy and thoracotomy procedures. However; pulmonary function (FVC) and RMS (Pimax) were more adversely affected following sternotomy compared to thoracotomy during the early postoperative period.