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"Latar belakang: Pasien pascabedah pintas arteri koroner (BPAK) mengalami penurunan fungsi paru akibat inflamasi perioperatif sehingga terjadi ketidakcocokan ventilasi/perfusi dan kelemahan otot pernapasan. Akibatnya saat beraktivitas, terjadi keterbatasan oksigen sehingga terjadi kelelahan otot lebih cepat dan kapasitas fungsional rendah. Latihan pernapasan diharapkan membantu memperbaiki kapasitas fungsional melalui perbaikan fungsi paru. Tujuan: Membuktikan manfaat latihan pernapasan terhadap kapasitas fungsional yang diukur dengan 6 Minutes walk test (6MWT) pada pasien pasca-BPAK yang menjalani rehabilitasi kardiovaskular fase II. Metode: Uji klinis dengan merandomisasi subjek pada kelompok perlakuan yang mendapat adjuvan latihan pernapasan atau menjalani program rehabilitasi standard. Diukur kapasitas inspirasi dan 6MWT pada awal dan akhir rehabilitasi fase II. Hasil: Dua puluh delapan subjek dirandomisasi menjadi 14 kelompok perlakuan dan 14 kelompok standard. Setelah menjalani program rehabilitasi, kelompok perlakuan dan standard mengalami peningkatan jarak 6MWT yang tidak berbeda bermakna (67 ± 62.9 meter VS. 53 ± 65.7 meter; p = 0.556 ) walau kelompok perlakuan mengalami peningkatan kapasitas inspirasi lebih baik daripada kelompok standard (1357 ± 691.4 mL VS 589 ± 411.5 mL; p = <0.001 ). Simpulan: Latihan pernapasan sebagai latihan adjuvan rehabilitasi kardiovaskular fase II pasca-BPAK tidak memperbaiki jarak 6MWT secara bermakna dibandingkan program rehabilitasi standard, hanya mempercepat perbaikan fungsi paru.

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Background : Patients undergoing coronary artery bypass graft (CABG) surgery develop pulmonary dysfunction due to inflammation and respiratory muscle weakness, hence ventilation/perfusion mismatch occurs then leads to low functional capacity. Respiratory training has been identified to improve functional capacity by recovering pulmonary function faster.

Objectives : To study respiratory training benefit as adjuvant training in 2 phase of cardiovascular rehabilitation program after CABG for improving functional capacity measured by 6 minutes walk test/6MWT distance.

Methods : This single blind clinical trial randomized subjects into intervention group or standard group. Intervention group received respiratory training up to 60% of maximum inspiratory volume (MIV) as an adjuvant to the standard program. Then MIV and 6MWT distance were evaluated.

Result : Twenty eight subjects participated, 14 subjects were in intervention group and others were in standard group. Six MWT distance improvement is not significantly different between groups (67 ± 62.9 VS. 53 ± 65.7 meters respectively; p = 0.556 ). However, intervention group experienced better MIV improvement compared to standard group (1357 ± 691.4 VS. 589 ± 411.5 mL; p = <0.001 ).

Conclusion : Respiratory training as adjuvant training did not improve 6MWT distance among patients undergoing CABG surgery significantly."

"Pasien PJK pasca CABG beresiko mengalami serangan berulang. Meskipun revaskularisasi berhasil, namun CABG tetap merupakan operasi paliatif, pasien tetap beresiko mengalami kejadian kardiovaskular di masa mendatang. Graft vena safena memiliki tingkat kegagalan hingga 20% setelah satu tahun dan setinggi 50 % setelah 5 tahun. Kegagalan cangkok/graft (setelah 1 bulan) akibat hyperplasia intimal dan aterosklerosis. (Kasper.Dennis L., Hauser, Stephen L, Jameson, J.Larry, Fauci, Anthony S, Longo, Dan Loscalzo, 2015). Pencegahan sekunder dilakukan sebagai upaya untuk menjaga patensi graft dan meningkatkan kualitas hidup tertinggi. Penelitian ini penelitian korelatif dengan desain cross-sectional. Responden penelitian ini pasien compos mentis post CABG 2 minggu sampai dengan 1 tahun di Rumah Sakit PJNHK, tidak ada keluhan sesak dan tidak nyeri dada, dengan jumlah adalah 106 responden yang direkrut secara teknik sampling. Hasil studi menunjukkan terdapat hubungan antara pengetahuan terhadap perilaku pencegahan sekunder paska CABG dengan p = 0,043, terdapat hubungan antara sikap terhadap perilaku pencegahan sekunder pasca CABG dengan p = 0,19, adanya hubungan pengetahuan terhadap sikap pencegahan sekunder paska CABG dengan p= 0,019. Pasien pasca CABG perlu mendapatkan edukasi tentang pencegahan sekunder secara berkesinambungan untuk meningkatkan kualitas hidup yang optimal.

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Patients with CHD after CABG are at risk for recurrent attacks. Despite successful revascularization, but CABG remains a palliative surgery, the patient remains at risk for future cardiovascular events. Saphenous vein grafts have a failure rate of up to 20% after one year and as high as 50% after 5 years. Graft failure (after 1 month) due to intimal hyperplasia and atherosclerosis. (Kasper. Dennis L., Hauser, Stephen L, Jameson, J. Larry, Fauci, Anthony S, Longo, Dan Loscalzo, 2015). Secondary prevention is carried out as an effort to maintain graft patency and improve the highest quality of life. This study is a correlative study with a cross-sectional design. Respondents in this study were patients with post-CABG compos mentis 2 weeks to 1 year at the PJNHK Hospital, there were no complaints of shortness of breath and no chest pain, with a total of 106 respondents recruited by sampling technique. The results of the study show that there is a relationship between knowledge on secondary prevention behavior after CABG with p = 0.043, there is a relationship between attitudes towards secondary prevention behavior after CABG with p = 0.19, there is a relationship between knowledge and attitudes for secondary prevention after CABG with p = 0.019. Post-CABG patients need to receive education about secondary prevention on an ongoing basis to improve optimal quality of life."