Monitoring Thoracic Surgery Patients: A Heart Rate Variability Perspective on Postoperative Recovery and Therapeutic Interventions

Abstract

Abstract Purpose In this study we aim to adopt heart rate variability (HRV) as a non-invasive monitoring technique to assess the recovery process of pulmonary surgery patients. In order to advance the recovery process, two different physiotherapy interventions; positive expiratory pressure (PEP) and inspiratory muscle training (IMT) were utilized to see how effectively they can enhance the recovery process. Methods Electrocardiogram (ECG) measurements were performed for 72 minor pulmonary (PM) and pulmonary resection (PR) surgery patients pre-operatively and on two first post-operative days and the recovery process was promoted using PEP and IMT therapeutic interventions by dividing the patients into two groups, one for each intervention. Time and frequency domain HRV parameters were calculated during different days and statistical analysis was performed between the days and the intervention groups. Results A reduction in all investigated HRV parameters was observed post-operatively. Low frequency components of HRV (LF power) faced the most significant reduction for PEP intervention of PM surgery group (from 290.02 ms2 to 229.04 ms2). There was no sign of recovery and returning to the baseline level within the two-day timeframe. Also, no statistically significant difference was found between intervention groups (\(\alpha\) \(\ge\) 0.05); however, IMT technique seemed to have a slightly improved effects for PM surgery group. Conclusion Based on the results, the investigated HRV parameters are able to assess the status of pulmonary surgery patients, the recovery process and inspecting the difference between therapeutic interventions; however, larger studies with extended monitoring timeframe and more subjects can possibly improve the results.