Are Incentive Spirometry, Intermittent Positive Pressure Breathing, and Deep Breathing Exercises Effective in the Prevention of Postoperative Pulmonary Complications After Upper Abdominal Surgery? A Systematic Overview and Meta-analysis

Thomas, Jasmin; McIntosh, John M.

doi:10.1093/ptj/74.1.3

Cited by 191 publications

(100 citation statements)

References 21 publications

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“…As in many centers, respiratory physiotherapy and early mobilization strategies are being performed from the first day of surgery in our center. [17][18][19][20][21] We believe that our strict postoperative treatment including early mobilization, respiratory physiotherapy (incentive spirometry, chest physical therapy, and hyperinflation therapy), and postoperative analgesic techniques could be responsible for this lower incidence of early postoperative atelectasis.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Ulubay

Dedekarginoglu²,

Küpeli̇³

et al. 2015

Exp Clin Transplant

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Objectives: Living-donor liver transplant has become a viable option and an important source of hepatic grafts. The goal of this study is to establish postoperative pulmonary complications of liver donation surgery in our center. Materials and Methods: Data from 188 subjects (median age, 33.7 ± 8.4 y; male/female, 51.1%/48.9%) who had liver donation surgery from 1988 to 2013 were analyzed retrospectively. Patient demographic and clinical features were recorded. Postoperative complications and the correlation of risk factors for postoperative pulmonary complications were investigated. Results: The incidence of early postoperative complications was 17% (n = 32), and 16 of these patients had postoperative pulmonary complications (8.5%); 2 of the postoperative pulmonary complications were detected on the day of surgery and the other 14 complications were observed between the second and seventh day after surgery. Most postoperative pulmonary complications were minor complications including atelectasis, pleural effusion, and pneumonia. There was 1 major postoperative pulmonary complication: pulmonary embolism that occurred on the fourth day after surgery in 1 patient. Late pulmonary complications also were reviewed and no late postoperative pulmonary complications were observed. There was no significant difference in early and late postoperative pulmonary complications between ex-smokers and smokers. Postoperative atelectasis was significantly higher in patients with body mass index ≤ 20 kg/m² than patients with body mass index > 21 kg/m² (P = .027). In our study population, no postoperative mortality was recorded. Conclusions: We believe that preoperative weight reduction strategies and early mobilization with postoperative respiratory physiotherapy could be important factors to reduce postoperative pulmonary complications in liver donors.

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Section: Discussionmentioning

confidence: 99%

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Ulubay

Dedekarginoglu²,

Küpeli̇³

et al. 2015

Exp Clin Transplant

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“…It has been shown that teaching patients these techniques preoperatively reduces pulmonary complications to a greater extent than instructions given after surgery [75]. Deep-breathing exercises and incentive spirometry are equally effective in reducing the risk of PPCs, and the latter is less labor-intensive [76]. A review found that these techniques consistently reduced the relative risk of pulmonary complications by approximately 50% [77].…”

Section: Risk-reduction Interventionsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.

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“…However, an IS seems to be more effective in improving respiratory muscle strength. Thomas and McIntosh [25] carried out a meta-analysis to analyze conflicting publications on the effectiveness of an IS, IPPB and deep breathing exercises in the prevention of postoperative pulmonary complications in patients who underwent upper abdominal operation. They concluded that deep breathing exercises and the use of an IS are most effective when compared to groups of patients who have not received any treatment.…”

Section: Physiotherapeutic Approach After Extubationmentioning

confidence: 99%

Cuidados pré e pós-operatórios em cirurgia cardiotorácica: uma abordagem fisioterapêutica

Arcêncio¹,

Souza²,

Bortolin³

et al. 2008

Rev Bras Cir Cardiovasc

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It is well known that anesthesia and certain surgeries predispose patients to changes in respiratory function, pulmonary volumes, and gas exchange. Cardiac surgery, which is considered a major surgery, may trigger respiratory complications in the postoperative period. These complications have various causes, such as heart and lung functions in the pre-operative, the use of cardiopulmonary bypass (CPB), and the level of sedation. In these extensive thoracic procedures, respiratory dysfunction may be significant, persisting in the postoperative period. Physiotherapy is offered to patients in the ICU as part of a multidisciplinary treatment plan. It is a time-consuming treatment, and is possible at various times during the patient's stay in the ICU. However, it is particularly valuable in postoperative recovery in order to avoid respiratory and motor complications. Thus, a literature review was performed, aiming to arrange current and relevant information on available resources for respiratory monitoring, as well as its importance in evaluating and treating lung function impairment, as this complication is a frequent cause of death in surgical patients. Bras Cir Cardiovasc 2008; 23(3): 400-410 For acquisition data in this study, scientific articles and an electronic research strategy was used for bibliographic reviews, mainly aiming to identify studies and guidelines that relate to physiotherapeutic performance and cardiothoracic surgery. The study was carried out based on articles that were published in the last 20 years, were available in the MEDLINE database, and used the terms "Physiotherapy", "cardiac surgery", "respiratory monitoring" and/or "respiratory complications". Relevant studies from Brazilian authors were also considered, particularly those published by the Brazilian Journal of Cardiovascular Surgery and the Brazilian Archives of Cardiology (official journals of dissemination of Brazilian cardiology) if the articles contained the key words "physiotherapy" and "monitoring". In addition to this research, additional data from postgraduate studies was found at the Division of Thoracic and Cardiovascular Surgery, FMRP-USP.ARCÊNCIO, L ET AL -Pre-and postoperative care in cardiothoracic surgery: a physiotherapeutic approach RevThe findings included randomized clinical trials, metaanalysis, review articles and consensus guidelines, and were related to physiotherapy, respiratory monitoring, and cardiac surgery and its complications. As the diagram of Figure 1 shows, 623 potentially relevant publications in MEDLINE were found, of which 55 fulfilled all of the scientific criteria.

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Are Incentive Spirometry, Intermittent Positive Pressure Breathing, and Deep Breathing Exercises Effective in the Prevention of Postoperative Pulmonary Complications After Upper Abdominal Surgery? A Systematic Overview and Meta-analysis

Cited by 191 publications

References 21 publications

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

Pre-operative pulmonary assessment for patients with hip fracture

Cuidados pré e pós-operatórios em cirurgia cardiotorácica: uma abordagem fisioterapêutica

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