Assessment of the strength of the respiratory muscles in the early stages after thoracic interventions

Introduction. The respiratory complications prevail among the causes of postoperative mortality in the thoracic surgery. The respiratory muscle (RM) dysfunction may be considered as one of the most important pathogenetic factors of such complications.

Aim. To evaluate the RM strength in the early postoperative period after thoracic surgery.

Materials and methods. 52 patients were examined after elective thoracoscopy and thoracotomy surgery. The first group consisted of 24 patients with duration of the operation for 90 minutes and the less. The second group included 28 persons with duration of the surgery for more than 90 minutes. RM strength was measured using “MicroRPM” (CareFusion, UK). Maximal inspiratory (MIP), expiratory (MEP) and nasal (SNIP) pressure indicators were estimated at the following time points: before surgery, in 60 minutes, 180 minutes and 24 hours after extubation.

Results. The significant differences between the strength indicators of RM were revealed inside the both groups at the different phases of the investigation. The drastic drop of all the strength indicators in comparison with the initial values was detected in 60 minutes after the extubation in the patients of both groups. The values increased in 180 minutes. 24 hours after the surgery the readings of RM strength retained the growth trend, but they did not reach the initial values. Evaluation of the remainder between RM strength indicators before the surgery and at the specific time point revealed the significant differences between the compared groups in the terms of the reduction extent for MIP at all the time points, and for SNIP in 180 minutes after extubation only.

Conclusion. These data show the more evident dynamics of RM strength restoration with thoracoscopic techniques being used, which allowed to decrease the surgery duration and to reduce cumulative dose of the muscle relaxant.

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