Start Strong, Finish Strong: A Review of Prehabilitation in Cardiac Surgery

Abstract

Cardiac surgery constitutes a significant surgical insult in a patient population that is often marred by significant comorbidities, including frailty and reduced physiological reserve. Prehabilitation programs seek to improve patient outcomes and recovery from surgery by implementing a number of preoperative optimization initiatives. Since the initial trial of cardiac prehabilitation twenty-four years ago, new data have emerged on how to best utilize this tool for the perioperative care of patients undergoing cardiac surgery. This review will explore recent cardiac prehabilitation investigations, provide clinical considerations for an effective cardiac prehabilitation program, and create a framework for future research studies.

Keywords: cardiac prehabilitation; exercise; nutrition; psychobehavioral.

Figure 1

The three major cardiac prehabilitation components are nutrition, exercise, and psychobehavioral support, each with three specific interventions trialed in the literature.