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After conventional cardiac surgery, many respiratory complications are possible. Therefore, the resuscitator prescribe physiotherapy and non invasive ventilation. The physiotherapist has few reliable tools to evaluate and follow the patient on his ventilatory function. Currently, lung ultrasound is little used in physiotherapy and no study explains the link between the lung ultrasound results and oxygenation patient state. Before considering the interest of lung ultrasound score as a criterion of effectiveness of a physiotherapy treatment through future studies, it is first important to objectivize the existence of a relationship between lung ultrasound score and the PaO2/FiO2 ratio after cardiac surgery. Lung ultrasound could provide direct clinical information without having to resort to other more invasive examinations to objectify the improvement of the patient's oxygenation.
Main objective To show that the relative change in the PaO2/FiO2 ratio correlates with the change in lung ultrasound score measured in the short term between the beginning and the end of the first physiotherapy session associated with non invasive ventilation the day after surgery in cardiac patients
Secondary objectives
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HEART SURGERY PATIENTS with cardio pulmonary bypass | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| blood gas via arterial catheter | Biological | Patients will have a blood sample plus a lung ultrasound before and after the physical therapy session combined with non invasive ventilation the morning after the heart surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Relative difference in PaO2/FiO2 ratio: (measurement after - measurement before the physiotherapy session + non invasive ventilation) / measurement before.) | The higher the ratio, better is the result. Between approximately 0 and 400 | the morning after the heart surgery |
| Difference in lung ultrasound score: measurement after - measurement before the physiotherapy session + non invasive ventilation | Lung ultrasound score = global measurement on 12 thoracic regions (6 per hemithorax: 2 anteriors, 2 laterals, 2 posteriors) to obtain a result out of 36 (sum of all values found in each zone). Each zone is evaluated as follows: 0 = normal ventilation
| the morning after the heart surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Lung ultrasound score values obtained by both evaluators from the same recorded ultrasound images. If there is a difference of one point between the two scores measured, a third reading by a doctor will be taken. This 3rd score will then be retained. | If there is a difference of one point between the two scores measured, a third reading by a doctor will be taken. This 3rd score will then be retained. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Aurélie roth oudin | Contact | 03 83 15 41 96 | a.roth@chru-nancy.fr |
| Name | Affiliation | Role |
|---|---|---|
| Jean PAYSANT | Central Hospital, Nancy, France | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| centralHNF | Recruiting | Vandœuvre-lès-Nancy | 54511 | France |
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| in the week following the measurements |
| relative difference in PaO2/FiO2 ratio | The higher the ratio, better is the result. Between approximately 0 and 400 | the morning after the heart surgery |
| difference in lung ultrasound score for each study area | Each zone is rated from 0 to 3 points. The lower the score, the better the result. We look to see if the score for each zone decreases between before and after the physiotherapy session. | the morning after the heart surgery |
| initial lung ultrasound score | Lung ultrasound score = global measurement on 12 thoracic regions (6 per hemithorax: 2 anteriors, 2 laterals, 2 posteriors) to obtain a result out of 36 (sum of all values found in each zone). Each zone is evaluated as follows: 0 = normal ventilation
| the morning after the heart surgery |
| relative difference in PaCO2 | The lower the score, the better the result. Ap proximately between 0 and 100 | the morning after the heart surgery and after physiotherapy session |
| For each subject, answers to two questions at the end of the session about his or her understanding of PAS after the information provided by the MK during the session | Questions asked by the physiotherapist for the patient (at the end of the session) :
Translated with www.DeepL.com/Translator (free version) | the morning after the heart surgery |