INTRODUCTION: This randomized controlled study evaluated the clinical benefit and physiological effects of prophylactic chest physiotherapy in open major abdominal surgery. METHODS: A group of 174 patients receivedchest physiotherapy including breathing with pursed lips, huffing and coughing, and information about the importance of early mobilization. In addition high-risk patients were given resistance training on inspiration and expiration with a mask. The resistance used during inspiration was -5 cmH2O and that during expiration +10 cmH2O. The control group (194 patients) received no information or treatment unless a pulmonary complication occurred. RESULTS:Oxygen saturation on postoperative days 1-3 was significantly greater in the treatment group. Treated patients were mobilized significantly earlier. No difference was noted in peak expiratory flow rate or forced vital capacity. Postoperative pulmonary complications occurred in 6 per cent of patients in the treatment group and in 27 per cent of controls (P < 0.001). In high-risk patients the numbers with pulmonary complications were six of 40 and 20 of 39 respectively. Pulmonary complications were particularly common in patients with morbid obesity. CONCLUSION:Preoperative chest physiotherapy reduced the incidence of postoperative pulmonary complications and improved mobilization and oxygen saturation after major abdominal surgery.
RCT Entities:
INTRODUCTION: This randomized controlled study evaluated the clinical benefit and physiological effects of prophylactic chest physiotherapy in open major abdominal surgery. METHODS: A group of 174 patients received chest physiotherapy including breathing with pursed lips, huffing and coughing, and information about the importance of early mobilization. In addition high-risk patients were given resistance training on inspiration and expiration with a mask. The resistance used during inspiration was -5 cmH2O and that during expiration +10 cmH2O. The control group (194 patients) received no information or treatment unless a pulmonary complication occurred. RESULTS:Oxygen saturation on postoperative days 1-3 was significantly greater in the treatment group. Treated patients were mobilized significantly earlier. No difference was noted in peak expiratory flow rate or forced vital capacity. Postoperative pulmonary complications occurred in 6 per cent of patients in the treatment group and in 27 per cent of controls (P < 0.001). In high-risk patients the numbers with pulmonary complications were six of 40 and 20 of 39 respectively. Pulmonary complications were particularly common in patients with morbid obesity. CONCLUSION: Preoperative chest physiotherapy reduced the incidence of postoperative pulmonary complications and improved mobilization and oxygen saturation after major abdominal surgery.
Authors: E Crema; A G Benelli; A V Silva; A J Martins; R Pastore; G H Kujavao; A A Silva; J R Santana Journal: Surg Endosc Date: 2004-11-18 Impact factor: 4.584
Authors: Carla Cristine Cunha Casali; Ana Paula Manfio Pereira; José Antônio Baddini Martinez; Hugo Celso Dutra de Souza; Ada Clarice Gastaldi Journal: Obes Surg Date: 2011-09 Impact factor: 4.129
Authors: Helge Bruns; Nuh N Rahbari; Thorsten Löffler; Markus K Diener; Christoph M Seiler; Matthias Glanemann; Giovanni Butturini; Christoph Schuhmacher; Inga Rossion; Markus W Büchler; Tido Junghans Journal: Trials Date: 2009-07-26 Impact factor: 2.279