A vénás és a légzőtorna szerepe a belgyógyászati ellátásban. Interdiszciplináris áttekintés a Thrombosisprevenciótól a sav-bázis homeosztázisig

Istvan Kusztor; László Kalabay

doi:10.59063/mba.2025.78.5-6.1

István Kusztor Semmelweis University, Department of Internal Medicine and Hematology
László Kalabay Dr. Semmelweis University Department of Internal Medicine and Hematology, Department of Family Medicine https://orcid.org/0000-0002-8329-3755

DOI: https://doi.org/10.59063/mba.2025.78.5-6.1

Keywords: venous exercise, breathing exercise, deep vein thrombosis, diaphragm-pump, acid-base homeostasis, medical rehabilitation

Abstract

Prolonged immobilization in internal medicine wards is a major risk factor for deep vein thrombosis (DVT) and postoperative pulmonary complications. Venous exercise – referred to as the ankle-pump exercise (APE) in the English-language literature – and respiratory exercise based on diaphragmatic training improve not only oxygenation but also haemodynamics, acid-base balance and visceral perfusion. This review highlights the patho-physiological foundations, evidence base and clinical protocols of these two therapeutic modalities and describes how they can be integrated into the routine care pathway of medical in-patients.

References

Heit JA: The epidemiology of venous thromboembolism. Nat Rev Cardiol 2016; 13: 464-474. https://doi.org/10.1038/nrcardio.2015.83

Gadó K, és mtsai: A belgyógyászati betegek thrombosis-prevenciója: fizioterápiás megközelítés. Magyar Belorv Arch 2024; 77: 45-52.

Zhang Q, Li H, Chen X és mtsai: Effects of ankle-pump exercise frequency on venous haemodynamics and fatigue in healthy adults. Med Sci Monit 2020; 26: e925604.

Liu Z, Tao X, Chen Y és mtsai: Bed rest versus early ambulation with standard anticoagulation in the anagement of deepvein thrombosis: A meta-analysis. Plos One 2015; 10: e0121388. https://doi.org/10.1371/journal.pone.0121388

Shao X, Cheng Y, Tan L és mtsai: Early ambulation versus bed rest for acute deep vein thrombosis: Systematic review and meta-analysis. Int J Cardiol 2009; 136: 203-206.

Li H, Zhang W, Lu Q és mtsai: Which frequency of Ankle Pump exercise should Be Chosen for the Prophylaxis of deep Vein thrombosis? Inquiry. 2022; 59: 1‑8. https://doi.org/10.1177/00469580221105989

Kwon OY, Jung DY, Kim Y és mtsai: Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein. Aust J Physiother 2003; 49: 253258. https://doi.org/10.1016/S0004-9514(14)60141-0

Aschwanden M, Labs KH, Engel H és mtsai: Acute deep vein thrombosis: early mobilization does not increase the frequency of pulmonary embolism. thromb Haemost 2001; 85: 42-46. https://doi.org/10.1055/s-0037-1612901

Padberg FT Jr, Johnston MV, Sisto SA: Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg 2004; 39: 79-87. https://doi.org/10.1016/j.jvs.2003.09.036

Lurie F, Passman M, Meisner M és mtsai: The 2020 update of the CeAP classification system and reporting standards. j Vasc Surg Venous lymphat disord 2020; 8: 342-352. https://doi.org/10.1016/j.jvsv.2019.12.075

Geleto G, Getnet W, Tewelde T: Mean normal Portal Vein diameter using sonography among Clients Coming to radiology department of jimma university Hospital, Southwest Ethiopia. Ethiop J Health Sci 2016; 26(3): 237-242. https://doi.org/10.4314/ejhs.v26i3.6

Abdullahi A, Wong TWI, Ng SS: Efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor function outcomes in patients with stroke: A systematic review and metaanalysis. Front Neurol. 2024; 14: 1233408. https://doi.org/10.3389/fneur.2023.1233408

Agostini P, Naidu B: Incentive spirometry for preventing postoperative pulmonary complications. Cochrane Database Syst Rev. 2013; 9: CD006058.

The role of venous and breathing exercise in internal medicine care. An interdisciplinary overview Thrombosis prevention to acid-base homeostasis

Abstract

References