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Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery.
J Am Osteopath Assoc. 2005 Oct; 105(10):475-81.JA

Abstract

CONTEXT

Coronary artery bypass graft (CABG) surgery is a common procedure for patients with coronary artery disease. The physiologic effects of postoperative osteopathic manipulative treatment (OMT) following CABG have not been documented previously.

OBJECTIVE

To determine the effects of OMT on cardiac hemodynamics post-CABG surgery.

DESIGN

Pilot prospective clinical study (N=29).

SETTING AND PATIENTS

Treatment subjects (n=10) undergoing CABG surgery were recruited for postoperative OMT. The primary assessment compared, pre-OMT versus post-OMT, measurements of thoracic impedance, mixed venous oxygen saturation (SvO2), and cardiac index. Records of control subjects (n=19) who underwent CABG surgery--but who did not receive OMT--were assessed for SvO2 and cardiac index at 1 hour and 2 hours postsurgery.

INTERVENTION

Immediately following CABG surgery (< or = 2 h), OMT was provided to subjects to alleviate anatomic dysfunction of the rib cage caused by median sternotomy and to improve respiratory function. This adjunctive treatment occurred while subjects were completely anesthetized.

RESULTS

A post-OMT increase in thoracic impedance (P < or = .02) in OMT subjects demonstrated that central blood volume was reduced after OMT, suggesting an improved peripheral circulation. Mixed venous oxygen saturation also increased (P < or = .005) after OMT. These increases were accompanied by an improvement in cardiac index (P < or = .01). Comparisons of postoperative measurements in OMT subjects versus those in control subjects revealed statistically significant differences for SvO2 (P < or = .005) and cardiac index (P < or = .02) between the two groups.

CONCLUSION

The observed changes in cardiac function and perfusion indicated that OMT had a beneficial effect on the recovery of patients after CABG surgery. The authors conclude that OMT has immediate, beneficial hemodynamic effects after CABG surgery when administered while the patient is sedated and pharmacologically paralyzed.

Authors+Show Affiliations

Department of Surgery, Texas College of Osteopathic Medicine, University of North Texas Health Center, Fort Worth, TX 76107, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16314680

Citation

O-Yurvati, Albert H., et al. "Hemodynamic Effects of Osteopathic Manipulative Treatment Immediately After Coronary Artery Bypass Graft Surgery." The Journal of the American Osteopathic Association, vol. 105, no. 10, 2005, pp. 475-81.
O-Yurvati AH, Carnes MS, Clearfield MB, et al. Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. J Am Osteopath Assoc. 2005;105(10):475-81.
O-Yurvati, A. H., Carnes, M. S., Clearfield, M. B., Stoll, S. T., & McConathy, W. J. (2005). Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. The Journal of the American Osteopathic Association, 105(10), 475-81.
O-Yurvati AH, et al. Hemodynamic Effects of Osteopathic Manipulative Treatment Immediately After Coronary Artery Bypass Graft Surgery. J Am Osteopath Assoc. 2005;105(10):475-81. PubMed PMID: 16314680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemodynamic effects of osteopathic manipulative treatment immediately after coronary artery bypass graft surgery. AU - O-Yurvati,Albert H, AU - Carnes,Michael S, AU - Clearfield,Michael B, AU - Stoll,Scott T, AU - McConathy,Walter J, PY - 2005/11/30/pubmed PY - 2006/1/13/medline PY - 2005/11/30/entrez SP - 475 EP - 81 JF - The Journal of the American Osteopathic Association JO - J Am Osteopath Assoc VL - 105 IS - 10 N2 - CONTEXT: Coronary artery bypass graft (CABG) surgery is a common procedure for patients with coronary artery disease. The physiologic effects of postoperative osteopathic manipulative treatment (OMT) following CABG have not been documented previously. OBJECTIVE: To determine the effects of OMT on cardiac hemodynamics post-CABG surgery. DESIGN: Pilot prospective clinical study (N=29). SETTING AND PATIENTS: Treatment subjects (n=10) undergoing CABG surgery were recruited for postoperative OMT. The primary assessment compared, pre-OMT versus post-OMT, measurements of thoracic impedance, mixed venous oxygen saturation (SvO2), and cardiac index. Records of control subjects (n=19) who underwent CABG surgery--but who did not receive OMT--were assessed for SvO2 and cardiac index at 1 hour and 2 hours postsurgery. INTERVENTION: Immediately following CABG surgery (< or = 2 h), OMT was provided to subjects to alleviate anatomic dysfunction of the rib cage caused by median sternotomy and to improve respiratory function. This adjunctive treatment occurred while subjects were completely anesthetized. RESULTS: A post-OMT increase in thoracic impedance (P < or = .02) in OMT subjects demonstrated that central blood volume was reduced after OMT, suggesting an improved peripheral circulation. Mixed venous oxygen saturation also increased (P < or = .005) after OMT. These increases were accompanied by an improvement in cardiac index (P < or = .01). Comparisons of postoperative measurements in OMT subjects versus those in control subjects revealed statistically significant differences for SvO2 (P < or = .005) and cardiac index (P < or = .02) between the two groups. CONCLUSION: The observed changes in cardiac function and perfusion indicated that OMT had a beneficial effect on the recovery of patients after CABG surgery. The authors conclude that OMT has immediate, beneficial hemodynamic effects after CABG surgery when administered while the patient is sedated and pharmacologically paralyzed. SN - 0098-6151 UR - https://www.unboundmedicine.com/medline/citation/16314680/Hemodynamic_effects_of_osteopathic_manipulative_treatment_immediately_after_coronary_artery_bypass_graft_surgery_ L2 - http://jaoa.org/article.aspx?volume=105&amp;page=475 DB - PRIME DP - Unbound Medicine ER -