Episode 54: Sternal Precautions: Is there a Standard?

In this episode Dr. Burriesci discusses the common question about sternal precautions: Is there a Standard?  As simple as this question may seem, there is a ton of nuance and a ton of variation across the country, across hospital systems and across surgeons. 

This is then followed up with the question: are these standards to restrictive? Are there other options? Should we be moving away from these “precautions”?  

This is not a new question.  We will go back to 2011 and discuss the evolution of this thought process.

In this episode:

-              Typical Sternal Precautions and the variations that exist

-              Discuss a more individualistic approach based on risk factors

-              Break down 4 articles starting from 2011 addressing these exact questions

-              Discuss Baylor’s protocol “Keep Your Move in the Tube”

Highly recommend reading these articles:

• Cahalin LP, LaPier TK, and Shaw DK: Sternal Precautions: Is it time for change? Precautions versus restrictions – a review of literature and recommendations for revision.  Cardiopulmonary Physical Therapy Journal 22(1), 2011, p 5-15 (on blackboard)
• Adams J et al. An alternative approach to prescribing sternal precautions after median sternotomy, “Keep Your Move in the Tube.” Bayl Univ Med Cent. 2016 Jan;29(1)97-100.
• Katijjahbe M et al. Sternal Management Accelerated Recovery Trial – standard restrictive v. modified sternal precautions following median sternotomy. Study Protocol for randomized control trial. April 2017;18:290. DOI 10.1186/s13063-017-1974-8
• Gach R, Triano S, Ogola GO, et al. “Keep Your Move in the Tube” safely increases discharge home following cardiac surgery. PM&R. 2021;13:1321–1330. https://doi.org/10.1002/pmrj.12562

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