The morbidity and mortality associated with cardiac surgery is commonly a consequence of pulmonary complications.  Improving lung function may reduce postoperative pulmonary complications.  While the benefit of postoperative physical therapy interventions is fairly well documented, there is a paucity of evidence in relation to the impact of preoperative physical therapy on postoperative pulmonary complications and reduce hospital stays after cardiac surgery. Identifying patients who have a higher risk of developing postoperative pulmonary complications and improving lung function preoperatively has potential to reduce post operative complications.

Questions to consider:

1. How realistic do you think it is to increase the physical fitness of patients requiring cardiac surgery preoperatively?
2. What precautions would be necessary when implementing physical fitness programmes for patients requiring cardiac surgery?
3. What are the advantages of undertaking systematic reviews in areas where there is limited evidence?
4. What are the limitations of undertaking systematic reviews when there only a few studies are included and included studies are based on small samples?

Article for discussion:

Hulzebos EH, Smit Y, Helders PP, et al. (2012) Preoperative physical therapy for elective cardiac surgery patients. Cochrane Database Syst Rev;11:CD010118

EBN Commentary at: http://bit.ly/ZWKUri

Abstract of Article at: http://bit.ly/17CgC4M

The discussion will take place Wednesday, April 17 (14.00 UK time) to Friday, April 19 (16.00 Eastern Canadian time), 2013.  Be sure to tweet your messages and include #ebnjc to be part of the discussion.