Pre-operative Preparation for Cardiac Surgery Utilising a Combination of Metabolic, Physical and Mental Therapy - 16/08/11
Correspondence to: Cardiac Surgical Research Unit, CJOB Cardiothoracic Department, Alfred Hospital, PO Box 315, Prahran 3181, Australia. Tel.: +61 3 9276 3684; fax: +61 3 9276 2317.Résumé |
Cardiac surgery represents major metabolic, physical and mental stresses associated with an increased production of reactive oxygen species. These stresses may hamper post-operative recovery, increasing hospitalisation times and operative mortality. We conducted a quality assurance and feasibility study to evaluate and monitor the safety and efficacy of a new program of combined pre-operative metabolic (enhanced antioxidant), physical and mental therapy to counter these stresses prior to cardiac surgery.
Methods |
Sixteen cardiac surgery patients received metabolic therapy consisting of the antioxidants coenzyme Q10 (CoQ10) (300mg) and ⍺-lipoic acid (300mg), combined with magnesium orotate (1200mg), and omega-3 fatty acids (3g) given daily for a mean 36±7 days up until the day of operation. Patients also received a regimen of physical therapy incorporating non-exhaustive, light exercise and stretching techniques. Mental therapy in the form of stress reduction, relaxation and music was also provided. Blood levels of CoQ10 and malondialdehyde (MDA) were measured and a quality of life (QoL) questionnaire (SF-36) was administered before, after the program and 1 month after surgery. A patient satisfaction survey was conducted at six weeks post-operatively.
Results |
During the pre-operative period, treated patients (n=16) showed significant improvements in QoL composite scores, physical (33.5±4.1 to 41.0±4.5, p=0.005) and mental (44.3±4.5 to 54.1±5.3, p=0.006). CoQ10 levels increased from 725.6±96.1nmol/l to 3019.9±546.4nmol/l (p=0.006), MDA levels decreased from 2.2±0.9μM to 1.4±0.7μM (p=0.013) and systolic blood pressure decreased from 140±4.0mmHg to 132±3.0mmHg (p=0.002). One month after surgery the treated group (n=14) demonstrated significant improvements from pre-operative baseline in QoL composite scores, physical (38.9±4.0 to 57.9±5.4, p=0.01) and mental (50.3±5.6 to 69.3±4.8, p=0.03) compared to a previously reported similar group of cardiac surgery patients (n=74) whose physical and mental scores decreased from 43.0 to 42.8 (p=0.05) and 53.8 to 49.8, respectively (p=0.05).
Conclusion |
These preliminary results suggest that a program of combined metabolic, physical and mental preparation before cardiac surgery is safe, feasible and may improve quality of life, lower systolic blood pressure, reduce levels of oxidative stress and thus has the potential to enhance post-operative recovery.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac surgery, Coenzyme Q10, Magnesium orotate, ⍺-Lipoic acid, Omega-3-fatty acids, Music, Relaxation
Plan
Vol 15 - N° 3
P. 172-181 - juin 2006 Retour au numéro
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