Sternum Support May Prevent Major Atelectasis After Median Sternotomy


Observations At The Karolinska University Hospital Stockholm, Sweden


The study aimed to determine if a sternum support vest could effectively lower the risk of pulmonary complications, specifically atelectasis, in patients who have undergone median sternotomy. The study compared two groups of patients: Group A, who underwent surgery before the vest was introduced, and Group B, who underwent surgery after the vest was introduced. The severity of atelectasis was quantified using scoring systems based on chest X-ray images. The study found that Group B had a significantly lower prevalence of complete or near complete lobar atelectasis compared to Group A, particularly among men. No other significant differences in complications were observed between the two groups.

Background:

Atelectasis and other pulmonary complications are common after cardiac surgery. The sternum support vest (Posthorax®) has been shown to reduce the risk of deep mediastinitis after median sternotomy. Observations at the Karolinska University Hospital have indicated that the vest may also reduce the risk of atelectasis. This study aimed to objectively assess if sternum support vest could significantly lower the risk of various pulmonary complications, including atelectasis, in patients who have undergone median sternotomy.

Methodology:

  • Two groups of patients were included in the study.
    • Group A (n = 67) underwent surgery before the introduction of the sternum support vest.
    • Group B (n = 80) underwent surgery after the introduction of the sternum support vest.
  • The median age and gender ratio were similar in both groups, with approximately 70% of the patients being male.
  • Scoring systems were created to quantify the severity of atelectasis in each lung lobe and pleural effusion on each side based on postoperative chest X-ray images.
  • Medical records were also reviewed to gather additional information.

Results:

  • Group B had a significantly lower prevalence of complete or near complete lobar atelectasis compared to Group A (p = 0.02).
  • This difference was observed primarily among men (p = 0.01).
  • No other significant differences in complications were found between Group A and Group B.

Conclusions:

  • The study provided the first evidence that a sternum support vest could lower the risk of complete atelectasis in men who have undergone median sternotomy.
  • However, the study did not find a significant difference in complications other than atelectasis between patients who used the sternum support vest and those who did not.

Please note that this summary is based on the information provided in the abstract of the research paper. For more detailed and accurate information, I recommend referring to the original source.