Overall, surgical trauma causes physiological changes at all levels of metabolism, including hormonal, hematological, metabolic, and immunological changes. The impact of these changes is related to the extent of the procedure as well as the patient’s ability to tolerate the stress response. To overcome the surgical stress response, the patient has to be physically fit for surgery to guarantee oxygen delivery and oxygen utilisation to cope with the increased metabolic demand. Patients with low physical fitness or low energy reserves (muscle mass), including malnourished or sarcopenic, are more vulnerable to surgical stress as they have fewer reserves to meet the demands following surgery.

Patients who are waiting for cardiac surgery might have a higher prevalence of frailty and loss of muscle mass and function, sarcopenia. Reduced preoperative state: fatigue, malnutrition, reduced physical fitness, anxiety, and depression are significant predictors of prolonged recovery. Prehabilitation will therefore exert a significant impact on this patient group.

Prehabilitation is an active approach to prepare patients for their upcoming surgery by enhancing their physical and mental well-being by:-

1. Physical conditioning

2. Nutritional optimisation

3. Psychological preparation

4. Smoking cessation

5. Pain management strategies

6. Optimisation of chronic health conditions

7. Education and empowerment

8. Early mobilisation