C.O OBASEKI

Background:
Laparotomy and thoracostomy are major invasive procedures that impose distinct physiological stresses on the cardiovascular system. The rate-pressure product (RPP), an index of myocardial oxygen demand, provides a reliable measure of cardiovascular workload following surgical interventions. Understanding how these procedures influence RPP is essential for physiotherapists
in planning safe and effective post-surgical rehabilitation.
Methods:
An observational prospective cohort design was employed. Forty surgical patients with a mean age (CTTD: 44.0 ± 12.43 years; Laparotomy: 42.4 ± 23.12 years) were recruited through simple random sampling and assigned to two groups: laparotomy (n = 20) and closed-tube thoracostomy drainage (CTTD) (n = 20). Cardiovascular parameters—systolic blood pressure (SBP) and pulse rate (PR)—were recorded preoperatively and at 24, 48, and 72 hours postoperatively using an automated monitor. RPP was computed as SBP × PR. Pain intensity was assessed using the Visual Analogue Scale (VAS). Data were analyzed using descriptive statistics, paired and independent t-tests, and repeated measures ANOVA, with significance set at p < 0.05.
Results:
Thirty-one patients (20 laparotomy, 11 CTTD) completed the study. Baseline SBP, PR, and RPP were comparable between groups. Both groups exhibited postoperative fluctuations in SBP and PR, yet RPP remained relatively stable across all time points. Paired t-tests revealed no significant changes in RPP within groups, though the laparotomy group showed significant reductions in PR at 24 and 48 hours (p < 0.001). Repeated measures ANOVA confirmed no significant time effect on RPP in either group (CTTD: F (3, 30) = 0.929, p = 0.439; laparotomy: F (3,57) = 1.536, p = 0.215). Between-group comparisons showed no significant RPP differences at any interval (p > 0.05). Mean VAS scores were similar (CTTD: 3.00 ± 0.82; laparotomy: 3.20 ± 0.76).
Conclusion:
Laparotomy and thoracostomy procedures exert comparable effects on myocardial workload, as indicated by stable RPP values across postoperative periods. These findings suggest that cardiovascular responses following both surgeries are similar and that physiotherapy prescriptions should be guided by individualized patient assessment rather than procedure type alone.
Keywords:
Laparotomy, Thoracostomy, Rate Pressure Product, Myocardial Workload, Postoperative Physiotherapy, Cardiovascular Response.

Background: Chest expansion and cough function are essential in managing critically ill patients. Chest expansion reflects respiratory muscle strength and lung compliance, assessed non-invasively using simple measurements. Cough function clears airway secretions and prevents complications like pneumonia, but it is often impaired in critically ill patients due to immobility and weakened respiratory mechanics. Exploring the relationship between chest expansion and cough function could enable better, non-invasive methods to assess and improve respiratory health in this population.Methods:This study employs a cross-sectional design to explore the relationship between chest expansion and cough function in critically ill patients. Participants were selected using a purposive sampling technique based on specific inclusion criteria.A sample size of 34 was determined through a power analysis, ensuring adequate statistical power to detect significant correlations. Results:This study included 34 participants (58.8% female, 41.2% male) with a mean age of 53. No significant correlations were found between cough function and chest expansion at any level (p > 0.05). However, a significant negative correlation was observed between age and cough function (r = -0.906, p = 0.021). Hypothesis testing confirmed no significant relationship between chest expansion and cough function but identified a decline in cough function with increasing age. Conclusion:This study explored the relationship between chest expansion and cough function in critically ill patients. Chest expansion, a non-invasive measure of respiratory mechanics, and cough function, essential for airway clearance, were evaluated in 34 participants with an average age of 53 years. While no significant correlation was found between chest expansion at any level and cough function, a negative correlation between age and cough function was observed, indicating a decline in cough effectiveness with advancing age. Gender differences were noted in chest expansion at the axilla and xiphoid levels, with males showing greater values, but no gender-based differences were observed in cough function.