A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery

Denehy, Linda; Carroll, Sara; Ntoumenopoulos, George; Jenkins, Susan

doi:10.1002/pri.231

Cited by 52 publications

(54 citation statements)

References 48 publications

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“…Trials of the use of noninvasive ventilation in patients who underwent lowrisk surgical procedures were generally small and reported only physiologic outcomes or found no difference in endotracheal intubation, hospital mortality or length of stay. 89,91,95,[97][98][99][102][103][104][105][106][107]109,111 The only exception was a recent large trial of continuous positive airway pressure by mask in 468 patients after cardiac surgery. 101 There was a reduction in a composite end point of pulmonary complications (arterial pressure of oxygen/fraction of inspired oxygen < 100, pneumonia or reintubation) and readmission to the ICU or an intermediate care unit.…”

Section: Prevention Of Respiratory Failurementioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

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Section: Prevention Of Respiratory Failurementioning

confidence: 99%

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Keenan¹,

Sinuff²,

Burns³

et al. 2011

Canadian Medical Association Journal

325

202

View full text Add to dashboard Cite

“…1,2 The reported incidence of PPCs ranges from 10% to 88%, depending on the definition used and the population studied. [1][2][3][4][5][6][7][8] The incidence of PPCs also depends on the procedure and on individual patients' postoperative risk factors. 1 Compared to peripheral surgery, thoracic and upper abdominal surgeries result in the highest incidence of PPCs.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Cheifetz¹,

Lucy²,

Overend³

et al. 2010

Physiotherapy Canada

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Purpose: Immobility and pain are modifiable risk factors for development of venous thromboembolism and pulmonary morbidity after major abdominal surgery (MAS). The purpose of this study was to investigate the effect of abdominal incision support with an elasticized abdominal binder on postoperative walk performance (mobility), perceived distress, pain, and pulmonary function in patients following MAS. Methods: Seventy-five patients scheduled to undergo MAS via laparotomy were randomized to experimental (binder) or control (no binder) groups. Sixty (33 male, 27 female; mean age 58 e 14.9 years) completed the study. Preoperative measurements of 6-minute walk test (6MWT) distance, perceived distress, pain, and pulmonary function were repeated 1, 3, and 5 days after surgery. Results: Surgery was associated with marked postoperative reductions (p < 0.001) in walk distance (P75-78%, day 3) and forced vital capacity (35%, all days) for both groups. Improved 6MWT distance by day 5 was greater (p < 0.05) for patients wearing a binder (80%) than for the control group (48%). Pain and symptom-associated distress remained unchanged following surgery with binder usage, increasing significantly (p < 0.05) only in the no binder group. Conclusion: Elasticized abdominal binders provide a non-invasive intervention for enhancing recovery of walk performance, controlling pain and distress, and improving patients' experience following MAS.Key Words: abdominal binder, abdominal surgery, Adapted Symptom Distress Scale, pain, 6-minute walk test RÉ SUMÉObjectif : L'immobilité et la douleur sont des facteurs de risque modifiables dans le dé veloppement de thrombo-embolie veineuse et de morbidité pulmonaire à la suite d'une intervention chirurgicale abdominale majeure. L'objectif de cette é tude é tait d'investiguer les effets d'un soutien de l'incision abdominale à l'aide d'une bande abdominale é lastique sur la marche (mobilité ) postopé ratoire, sur la douleur perç ue, la douleur et la fonction pulmonaire des patients à la suite d'une telle intervention. Mé thode : 75 sujets appelé s à subir une chirurgie abdominale majeure par laparotomie ont é té choisis de fac¸on alé atoire pour faire partie du groupe expé rimental (avec bande abdominale) et d'un groupe de contrô le (sans bande abdominale). De ce nombre, 60 (33 hommes et 27 femmes dont la moyenne d'â ge é tait de 58 e 14,9 ans) ont participé à l'é tude jusqu'à la fin. Les mesures pré opé ratoires comprenaient un test de marche de 6 minutes (TM6), une mesure du degré de douleur perç u, de la douleur et de la fonction pulmonaire; ces mesures ont aussi é té prises aux jours 1, 3 et 5 suivant l'intervention. Ré sultats : L'intervention chirurgicale a é té associé e à des diminutions postopé ratoires marqué es (p < 0.001) dans la distance de marche (P75-78 %, au jour 3) la capacité pulmonaire forcé e (35 %, tous les jours), et ce, pour les deux groupes. L'amé lioration du TM6 au jour 5 a toutefois é té plus importante (p < 0,05) chez les sujets portant une bande abdominale (80 %)...

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“…Chest physiotherapy has been shown to prevent or even to improve breathing complications such as secretions, atelectasis and pneumonia, using a variety of techniques. 20 Together with postoperative care, respiratory physiotherapy techniques seem to provide some benefit in reducing pulmonary complications. 1,3,7,[20][21][22] The postoperative spirometry results presented in this study by the two groups did not show any significant differences.…”

Section: Resultsmentioning

confidence: 99%

Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial

et al. 2008

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CONTEXT AND OBJECTIVE: Abdominal surgical procedures increase pulmonary complication risks. The aim of this study was to evaluate the effectiveness of chest physiotherapy during the immediate postoperative period among patients undergoing elective upper abdominal surgery. DESIGN AND SETTING:This randomized clinical trial was performed in the post-anesthesia care unit of a public university hospital.METHODS: Thirty-one adults were randomly assigned to control (n = 16) and chest physiotherapy (n = 15) groups. Spirometry, pulse oximetry and anamneses were performed preoperatively and on the second postoperative day. A visual pain scale was applied on the second postoperative day, before and after chest physiotherapy. The chest physiotherapy group received treatment at the post-anesthesia care unit, while the controls did not. Surgery duration, length of hospital stay and postoperative pulmonary complications were gathered from patients' medical records. RESULTS:The control and chest physiotherapy groups presented decreased spirometry values after surgery but without any difference between them (forced vital capacity from 83.5 ± 17.1% to 62.7 ± 16.9% and from 95.7 ± 18.9% to 79.0 ± 26.9%, respectively). In contrast, the chest physiotherapy group presented improved oxygen-hemoglobin saturation after chest physiotherapy during the immediate postoperative period (p < 0.03) that did not last until the second postoperative day. The medical record data were similar between groups.

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A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery

Abstract: The addition of PCPAP to a traditional physiotherapy post-operative treatment regimen after upper abdominal surgery did not significantly affect physiological or clinical outcomes.

Cited by 52 publications

References 48 publications

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting

The Effect of Abdominal Support on Functional Outcomes in Patients Following Major Abdominal Surgery: A Randomized Controlled Trial

Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial

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