PubMed · 14790075
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A M VAUGHN, A C GUZAUSKAS, W R T METZNER. 1950. Early postoperative ambulation.. https://doi.org/10.1016/0002-9610(50)90418-1
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Major surgery is associated with a decrease in muscle strength, muscle mass and functional performance. However, early intervention with intensive physical training seems to counteract the loss in muscle mass and muscle function as well as to shorten the postoperative length of stay in hospital. In addition, a sufficient intake of protein seems to be a central element in the treatment of postoperative patients to reduce the protein degradation normally seen with immobilisation and surgery. Knowledge regarding the potential effect of preoperative physical activity is sparse.
Postoperative pulmonary complications are a major problem after upper abdominal or thoracoabdominal surgery. They lead to a prolonged ICU stay as well as increased costs and are one of the main causes of early postoperative mortality. Even after uncomplicated operations, postoperative hypoxemia occurs in 30-50% of patients. Acute respiratory failure involves a disturbance in gas exchange. The mortality ranges from 10 to 60% according to the severity of respiratory failure. The most important complications are interstitial and alveolar pulmonary edema, atelectasis, postoperative pneumonia, hypoventilation, and aspiration. Preoperative optimization, postoperative prophylaxis according to a stepwise approach, and early mobilization decrease the rate of complications.
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