Body composition during perioperative phase of open‑heart surgery

Lean body mass decreases after a major operation such as open‑heart surgery which leads to postoperative complications as a drastic loss of muscle mass is related to infections and lon‑ ger hospital stays. The purpose of this study was to examine changes in lean body mass and muscle mass including body composition the perioperative phase until discharge in patients un‑ dergoing open‑heart surgery. Body fluids fat and lean body mass in 17 patients were determined before and 1 week after surgery and at discharge using bioelectrical impedance analysis. In addition the levels of hemo‑ globin albumin and C‑reactive protein in blood were measured. Cardiac rehabilitation consisted of early mobilization and aerobic bicycle exercise was subsequently performed after confirma‑ tion of independent walking for 200 meters. Early mobilization after surgery was assisted by physical therapists experienced in cases of cardiovascular surgery. Early mobilization required no more than 3 delayed days and no major complications until discharge in any of the patients. Weight and body mass index were significantly lower at dis‑ charge than before and 1 week after surgery while lean body mass muscle mass total body water intracellular fluid body protein and body cell mass values were significantly lower at discharge than before surgery. The changes in body composition seen after cardiac surgery until discharge indicated con‑ tinuous catabolic reactions in our patients and some cytokines have been suggested to influence this phenomenon. After receiving open‑heart surgery it is important for patients to receive nu‑ tritional therapy and begin resistance exercise as soon as possible. Aerobic exercise should pro‑ duce muscle protein synthesis and increase muscle mass under adequate nutritional support in‑ cluding specific amino acid supplements. Our findings indicate that muscle mass and nutritional status should be monitored after discharge and followed consistently in patients after open‑heart surgery.