Orthostatic intolerance during early mobilization following thoracoscopic lung resection: a prospective observational study.
Humans
Female
Male
Prospective Studies
Middle Aged
Lung Neoplasms
/ surgery
Early Ambulation
Orthostatic Intolerance
/ etiology
Pneumonectomy
/ adverse effects
Aged
Postoperative Complications
/ epidemiology
Thoracic Surgery, Video-Assisted
/ methods
Prevalence
Adult
Length of Stay
/ statistics & numerical data
Early mobilization
Factors
Lung resection
Orthostatic intolerance
Postoperative
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
16 Sep 2024
16 Sep 2024
Historique:
received:
17
05
2024
accepted:
03
09
2024
medline:
17
9
2024
pubmed:
17
9
2024
entrez:
16
9
2024
Statut:
epublish
Résumé
Early postoperative mobilization is important for enhanced recovery but can be hindered by orthostatic intolerance. However, study on postoperative orthostatic intolerance in thoracoscopic lung resection is limited. Thus, this investigation aims to examine the prevalence and variables contributing to orthostatic intolerance on the first day following thoracoscopic lung cancer resection. A prospective observational study was conducted from February 01 to May 05, 2023, at the First Affiliated Hospital of Chongqing Medical University. Typically, 215 subjects subjected to thoracoscopic lung resection were enrolled in this study. Their general information, disease, and treatment information were collected, and the occurrence of orthostatic intolerance was recorded. Typically, 64 patients (29.77%) demonstrated orthostatic intolerance during early mobilization, and 43.75% failed to walk. The prevalence of nausea, dizziness, and impaired vision was 60.94%, 92.19%, and 25.00%, respectively, and no patient experienced syncope. The factors shown to be independently linked with orthostatic intolerance were being female (OR = 2.98, 1.53 to 5.82) and high pain level during sitting (OR = 2.69, 1.79 to 4.04). Individuals with orthostatic intolerance had a longer postoperative hospital stay with a mean of 5.42 days against 4.25 days (p = 0.003). Orthostatic intolerance was prevalent following thoracoscopic lung cancer resection and affected patients' capability to mobilize and prolonged postoperative hospitalization. Being female and having high pain levels during sitting were identified as independent factors for orthostatic intolerance. This suggests that more emphasis should be given to risky patients, and for these groups, we may optimize pain management to adjust the risk of emerging orthostatic intolerance, facilitating early mobilization and early postoperative rehabilitation.
Sections du résumé
BACKGROUND
BACKGROUND
Early postoperative mobilization is important for enhanced recovery but can be hindered by orthostatic intolerance. However, study on postoperative orthostatic intolerance in thoracoscopic lung resection is limited. Thus, this investigation aims to examine the prevalence and variables contributing to orthostatic intolerance on the first day following thoracoscopic lung cancer resection.
METHODS
METHODS
A prospective observational study was conducted from February 01 to May 05, 2023, at the First Affiliated Hospital of Chongqing Medical University. Typically, 215 subjects subjected to thoracoscopic lung resection were enrolled in this study. Their general information, disease, and treatment information were collected, and the occurrence of orthostatic intolerance was recorded.
RESULTS
RESULTS
Typically, 64 patients (29.77%) demonstrated orthostatic intolerance during early mobilization, and 43.75% failed to walk. The prevalence of nausea, dizziness, and impaired vision was 60.94%, 92.19%, and 25.00%, respectively, and no patient experienced syncope. The factors shown to be independently linked with orthostatic intolerance were being female (OR = 2.98, 1.53 to 5.82) and high pain level during sitting (OR = 2.69, 1.79 to 4.04). Individuals with orthostatic intolerance had a longer postoperative hospital stay with a mean of 5.42 days against 4.25 days (p = 0.003).
CONCLUSIONS
CONCLUSIONS
Orthostatic intolerance was prevalent following thoracoscopic lung cancer resection and affected patients' capability to mobilize and prolonged postoperative hospitalization. Being female and having high pain levels during sitting were identified as independent factors for orthostatic intolerance. This suggests that more emphasis should be given to risky patients, and for these groups, we may optimize pain management to adjust the risk of emerging orthostatic intolerance, facilitating early mobilization and early postoperative rehabilitation.
Identifiants
pubmed: 39285467
doi: 10.1186/s12893-024-02556-3
pii: 10.1186/s12893-024-02556-3
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
265Subventions
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-12
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-12
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-12
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-12
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-07
Organisme : The Nursing Research Foundation of the First Affiliated Hospital of Chongqing Medical University
ID : HLJJ2022-07
Informations de copyright
© 2024. The Author(s).
Références
Sung H, Ferlay J, Rebecca L, et al. Global cancer statistics 2020: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clinicians. 2021;71:209–49.
Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends,and determinants. Chin Med J. 2022;135:584–90.
doi: 10.1097/CM9.0000000000002108
pubmed: 35143424
pmcid: 8920425
Granell-Gil M, Murcia-Anaya M, Sevilla S, et al. Clinical guide to perioperative management for videothoracoscopy lung resection (section of Cardiac, vascular and thoracic anesthesia, SEDAR; Spanish Society of thoracic surgery, SECT; Spanish Society of Physiotherapy). Revista Española De Anestesiología Y Reanimación (English Edition). 2022;69:266–301.
doi: 10.1016/j.redare.2021.03.015
pubmed: 35610172
Lu Y, Yuan Z, Han Y, et al. Summary of best evidence for enhanced recovery after surgery for patients undergoing lung cancer operations. Asia-Pacific J Oncol Nurs. 2022;9:100054.
doi: 10.1016/j.apjon.2022.03.006
Zhang W, Zhang Y, Qin Y, et al. Outcomes of enhanced recovery after surgery in lung cancer a systematic review and meta-analysis. Asia-Pacific J Oncol Nurs. 2022;9:100110.
doi: 10.1016/j.apjon.2022.100110
Gobezie NZ, Endalew NS, Tawuye HY, et al. Prevalence and associated factors of postoperative orthostatic intolerance at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022: cross sectional study. BMC Surg. 2023;23:108.
doi: 10.1186/s12893-023-02015-5
pubmed: 37127603
pmcid: 10150513
Eriksen JR, Munk-Madsen P, Kehlet H, et al. Orthostatic intolerance in enhanced recovery laparoscopic colorectal resection. Acta Anaesthesiol Scand. 2019;63:171–7.
doi: 10.1111/aas.13238
pubmed: 30094811
Skarin MU, Rice DA, McNair PJ, et al. Orthostatic intolerance following hip arthroplastyincidence, risk factors and effect on length of stay: a prospective cohort study. Eur J Anaesthesiol. 2019;36:123–9.
doi: 10.1097/EJA.0000000000000940
pubmed: 30540643
Hristovska AM, Andersen LB, Grentoft M, et al. Orthostatic intolerance after fast-track knee arthroplasty: incidence and hemodynamic pathophysiology. Acta Anaesthesiol Scand. 2022;66:934–43.
doi: 10.1111/aas.14098
pubmed: 35680697
Hardy P-YJ-P, Tavano A, Jacquet SV, et al. The impact of orthostatic intolerance on early ambulation following abdominal surgery in an enhanced recovery programme. Acta Anaesthesiol Scand. 2022;66:454–62.
doi: 10.1111/aas.14034
pubmed: 35118648
Mizota T, Iwata Y, Daijo H, et al. Orthostatic intolerance during early mobilization following video-assisted thoracic surgery. J Anesth. 2013;27:895–900.
doi: 10.1007/s00540-013-1634-4
pubmed: 23670803
Hanada M, Tawara Y, Miyazaki T, et al. Incidence of orthostatic hypotension and cardiovascular response to postoperative early mobilization in patients undergoing cardiothoracic and abdominal surgery. BMC Surg. 2017;17:111.
doi: 10.1186/s12893-017-0314-y
pubmed: 29183368
pmcid: 5704500
Campos TF, Vertzyas N, Wolden M, et al. Orthostatic intolerance-type events following hip and knee arthroplasty:a systematic review and Meta-analysis. J Bone Joint Surg Am. 2023;105:239–49.
doi: 10.2106/JBJS.22.00600
pubmed: 36723468
Neuprez A, Neuprez AH, Kaux JF, et al. Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years. Clin Rheumatol. 2020;39:861–71.
doi: 10.1007/s10067-019-04811-y
pubmed: 31720892
Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the enhanced recovery after surgery (ERASVR) Society and the European Society of thoracic surgeons (ESTS). Eur J Cardiothorac Surg. 2019;55(1):91–115.
doi: 10.1093/ejcts/ezy301
pubmed: 30304509
Jans Ø, Kehlet H. Postoperative orthostatic intolerance: a common perioperative problem with few available solutions. Can J Anesth/J Can Anesth. 2017;64:10–5.
doi: 10.1007/s12630-016-0734-7
Qin F, Li QP, Chen X, et al. Assessment and coping with early out-of-bed mobilization of patients after surgery:a review. J Nurs Sci. 2020;35(05):101–5.
Kuang H, Hou HR. The effect of nursing Assessment of active Pain after Lung Cancer surgery on the quality of Pain Management. Chin Gen Pract. 2021;24(S2):203–5.
Tong BD, Li GY, Tian X, et al. Study on influencing factors of Orthostatic Intolerance in adolescent idiopathic scoliosis patients. Chin Nurs Manage. 2022;22(01):17–21.
The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology. 1996;46(5):1470.
doi: 10.1212/WNL.46.5.1470
Vernino S, Bourne KM, Stiles LE, et al. Postural orthostatic tachycardia syndrome (POTS): state of the science and clinical care from a 2019 national institutes of health expert consensus meeting - Part 1. Auton Neuroscience: Basic Clin. 2021;235:102828.
doi: 10.1016/j.autneu.2021.102828
Zhang YQ, Wei X, Xie SH, et al. Use of opioid analgesics during postoperative hospitalization in patients undergoinglung resection and its influencing factors: a retrospective cohort study. Chin J Clin Thorac Cardiovasc Surg. 2022;29(07):909–13.
Cheng GHM, Tan GKY, Kamarudin MF, et al. Steroids significantly decrease postoperative postural hypotension in total knee replacement. J Knee Surg. 2021;36:208–15.
pubmed: 34237779
Xu JY, Shi CX, Zhang Y, et al. Research Progress on Orthostatic Intolerance after Hip/Knee arthroplasty. Shanghai Nurs. 2022;22(1):57–61.
Yan XM, He M, Wang XL. Research progress on the status quo and influencing factors of orthostatic intolerance in postoperative patients. Chinese Evidence-Based Nursing. 2022;8(24):3336–8.
Hristovska AM, Uldall-Hansen B, Mehlsen J, et al. Orthostatic intolerance after acute mild hypovolemia: incidence, pathophysiologic hemodynamics, and heart-rate variability analysis-a prospective observational cohort study. Can J Anesthesia/J Can Aanesth. 2023;70:1587–99.
doi: 10.1007/s12630-023-02556-6
Li C, He W. Progress in diagnosis and treatment of orthostatic intolerance. Chin J Geriatr. 2023;42(6):750–3.
Kurkis GM, Dennis DA, Johnson RM, et al. Incidence and risk factors of Orthostasis after primary hip and knee arthroplasty. J Arthroplast. 2022;37:S70–5.
doi: 10.1016/j.arth.2022.01.035
Reulecke S, Charleston-Villalobos S, Voss A, et al. Dynamics of the cardiovascular autonomic regulation during orthostatic challenge is more relaxed in women. Biomed Eng/Biomed Tech. 2017;63:139–50.
doi: 10.1515/bmt-2016-0150
Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102:1884–98.
doi: 10.1213/01.ANE.0000219597.16143.4D
pubmed: 16717343
Dai F. Application of non thoracic catheter in single hole thoracoscopic surgery in accelerated rehabilitation surgery. Yanbian University; 2022.
Moka E, Allam A, Rekatsina M, et al. Current approaches to four Challenging Pain syndromes. Cureus. 2023;15(9):e45573.
pubmed: 37868397
pmcid: 10586888
Nielsen MB, Jans Ø, Müller RG, et al. Does goal-directed fluid therapy affect postoperative orthostatic intolerance: a Randomized Trial. Anesthesiology. 2013;119:813–23.
doi: 10.1097/ALN.0b013e31829ce4ea