Literature DB >> 30722696

The effects of five days of intensive preoperative inspiratory muscle training on postoperative complications and outcome in patients having cardiac surgery: a randomized controlled trial.

Xiaoyu Chen1,2, Lin Hou1,2, Yuanyuan Zhang1,2, Xiangjing Liu1, Bohan Shao1, Bo Yuan1, Jing Li1, Min Li3, Hong Cheng3, Lei Teng3, Mingdi Guo3, Zhengqing Wang3, Tienan Chen3, Jianjun Liu3, Yaping Liu3, Zhigang Liu3, Xiaocheng Liu3, Qi Guo1,2.   

Abstract

OBJECTIVE: To determine the prophylactic efficacy of short-term intensive preoperative inspiratory muscle training on the incidence of postoperative pulmonary complications in patients scheduled for cardiac surgery.
DESIGN: Single-blind, randomized controlled pilot study.
SETTING: TEDA International Cardiovascular Hospital, China.
SUBJECTS: In total, 197 subjects aged ⩾50 years scheduled for cardiac surgery were selected. INTERVENTION: The intervention group ( n = 98) received five days of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group ( n = 99). MAIN MEASURES: The primary outcome variable was the occurrence of postoperative pulmonary complications. The secondary outcome variables were inspiratory muscle strength, lung function and length of hospitalization.
RESULTS: After cardiac surgery, a total of 10 (10.2%) of the 98 patients in the intervention group and 27 (27.3%) of 99 patients in the control group had postoperative pulmonary complications (risk ratio, 0.23; 95% confidence interval (CI), 0.09-0.58, P = 0.002). The study revealed that, compared with the control group, the intervention group had a significant increase in inspiratory muscle strength (by 10.48 cm H2O, P < 0.001), forced expiratory volume in the first second of expiration (FEV1) %predicted (by 3.75%, P = 0.030), forced vital capacity (FVC) %predicted (by 4.15%, P = 0.008) and maximal voluntary ventilation (MVV) %predicted (by 6.44%, P = 0.034). Length of hospital stay was 7.51 (2.83) days in the intervention group and 9.38 (3.10) days in the control group ( P = 0.039).
CONCLUSION: A five-day intensive pattern of preoperative inspiratory muscle training reduced the incidence of postoperative pulmonary complications and duration of postoperative hospitalization in patients undergoing cardiac surgery.

Entities:  

Keywords:  Cardiac surgery; inspiratory muscle training; length of stay; postoperative pulmonary complications

Mesh:

Year:  2019        PMID: 30722696     DOI: 10.1177/0269215519828212

Source DB:  PubMed          Journal:  Clin Rehabil        ISSN: 0269-2155            Impact factor:   3.477


  9 in total

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6.  Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis.

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