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Original Article
Nursing
Early postoperative 6-minute walk test in cardiac surgery patients: an observational study assessing safety, feasibility, and predictors of completion in India
Prasanth Jayaraman, Puvaneswari Kanagaraj, Shrinivas Hittalamani
Acute Crit Care. 2025;40(4):614-626.   Published online November 28, 2025
DOI: https://doi.org/10.4266/acc.000050
  • 2,269 View
  • 89 Download
AbstractAbstract PDFSupplementary Material
Background
Early mobilization after cardiac surgery is crucial for enhancing recovery, minimizing complications, and promoting timely discharge. The 6-minute walk test (6MWT) is a validated measure of functional capacity; however, its use during the early postoperative period—particularly in Intensive care Unit (ICU) settings in India—remains underexplored. This study assesses the safety, feasibility, and functional performance outcomes of the 6MWT administered on postoperative days (PODs) 2 to 4 and identifies factors associated with test completion.
Methods
A cohort-based observational study was conducted in a tertiary care ICU between June and September 2021. In total, 150 cardiac surgery patients aged 30–70 years were enrolled. Inclusion required hemodynamic stability, no vasopressor/inotropic support, and ambulation from POD 2. The 6MWT was administered per the American Thoracic Society guidelines. Clinical, demographic, and physiological parameters were recorded and analyzed using descriptive statistics, paired t-tests, and regression analyses.
Results
Of the 150 patients, 140 completed the test. The mean age was 52±14 years, and 75% of participants were male. Mean walking distances improved from 78.14 m (21.7% of predicted) on POD 2 to 193.51 m (53.75%) on POD 4. Completion rates increased from 40.0% to 99.2%. Physiological responses remained within safe limits, and no serious adverse events occurred. The regression analyses identified education, diet, and oxygen saturation as positive predictors and comorbidities, being female, oxygen use, and physical occupation as negative predictors.
Conclusions
The 6MWT is a safe, feasible, and informative tool for assessing early functional recovery in stable post-cardiac surgery ICU patients to aid individualized rehabilitation and discharge planning.
Case Report
Thoracic surgery
Early laparoscopic exploration for acute mesenteric ischemia after cardiac surgery
Sue Hyun Kim, Ho Young Hwang, Min Jung Kim, Kyu Joo Park, Ki-Bong Kim
Acute Crit Care. 2020;35(3):213-217.   Published online April 19, 2019
DOI: https://doi.org/10.4266/acc.2018.00423
  • 13,982 View
  • 236 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Acute mesenteric ischemia (AMI) after cardiac surgery is a rare but fatal complication. Early diagnosis and intervention can be lifesaving. We report two cases of patients who underwent early diagnostic laparoscopy for suspicious AMI after cardiac surgery and demonstrated favorable outcomes. An 83-year-old male with severe left ventricular dysfunction underwent off-pump coronary artery bypass grafting. Severe ileus with gaseous distension of the small bowel was developed on the 3rd postoperative day and computed tomographic angiography (CTA) showed pneumatosis intestinalis of small bowel suggestive of AMI. An immediate bedside laparoscopy was performed and it showed preserved perfusion of small bowel. He recovered without complication under supportive medical management. Another 69-year-old male who underwent aortic valve replacement complained of whole abdominal tenderness with severe distension on the 3rd postoperative day. The CTA found segmental non-enhancing bowel wall with air bubbles suggestive of AMI with possible microperforation. A diagnostic laparoscopy demonstrated small-bowel infarction with pus-like fluid collection in the peritoneal cavity. The operation was converted to laparotomy and complete resection of ischemic segments of small bowel was done. He recovered well without any other complications and discharged home on the 35th postoperative day.

Citations

Citations to this article as recorded by  
  • The Challenge of Pneumatosis Intestinalis: A Contemporary Systematic Review
    Gennaro Perrone, Mario Giuffrida, Valentina Donato, Gabriele Luciano Petracca, Giorgio Rossi, Giacomo Franzini, Sara Cecconi, Alfredo Annicchiarico, Elena Bonati, Fausto Catena
    Journal of Personalized Medicine.2024; 14(2): 167.     CrossRef
  • Gastrointestinal complications after cardiac surgery
    Klara Schwarzova, Sameer Damle, Frank William Sellke, Michael Phillip Robich
    Trauma Surgery & Acute Care Open.2024; 9(1): e001324.     CrossRef
  • The role of bed-side laparoscopy in the management of acute mesenteric ischemia of recent onset in post-cardiac surgery patients admitted to ICU
    Carlo Bergamini, Giovanni Alemanno, Alessio Giordano, Desiré Pantalone, Giovanni Fontani, Anna Maria Di Bella, Veronica Iacopini, Paolo Prosperi, Jacopo Martellucci
    European Journal of Trauma and Emergency Surgery.2022; 48(1): 87.     CrossRef
  • Minimally invasive acute care surgery
    Caroline E. Reinke, Robert B. Lim
    Current Problems in Surgery.2022; 59(2): 101031.     CrossRef
  • In Brief
    Caroline E. Reinke, Robert B. Lim
    Current Problems in Surgery.2022; 59(2): 101033.     CrossRef
  • Mesenteric ischemia postcardiac surgery—Elusive and less stratified complexity
    Mohammed Idhrees, Ian Williams, Mohamad Bashir, Bashi V. Velayudhan
    Journal of Cardiac Surgery.2022; 37(7): 2040.     CrossRef
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