Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Müller, Andrea; Olandoski, Márcia; Macedo, Rafael Michel de; Costantini, Constantino; Guarita-Souza, Luiz César

doi:10.1590/s0066-782x2006000300012

Cited by 25 publications

(35 citation statements)

References 17 publications

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“…Positive effects were observed with the use of NIV, including improvements in BIPP [25,27], BIPP associated with PEP [30], CPAP [24][25][26] and BiPAP [24,26] in the first days after HS, when the breathing is characterized by low tidal volume, offset by increased respiratory rate [24]. The adoption of this pattern of breathing tends to favor the development and continuity of atelectasis and changes in gas exchange [25,26]. Compared to CPAP [25] and IS [27], BIPP was considered more effective in increasing tidal volume, providing pulmonary re-expansion with less ventilation function [25,27].…”

Section: Resultsmentioning

confidence: 97%

“…Among the studies included, incentive spirometry (IS) was performed in three of them [20,24,27], deep breathing exercises (DBE) were used in six [20,21,23,[28][29][30]; DBE associated with positive expiratory pressure (PEP) was used in four [21,22,28,29] and PEP associated with respiratory resistance (PEP-IR) was used in two [21.28]. Breathing with intermittent positive pressure (BIPP) was used in three studies [25,27,30]; continuous positive airway pressure (CPAP) was used in two [24 , 26], bi-level positive airway pressure (BiPAP) was used in three studies [24][25][26]. Two clinical trials used a control group that didn't receive respiratory physiotherapy [22.23].…”

Section: Resultsmentioning

confidence: 99%

“…In one study [24], IS was associated with less favorable results in the improvement of VC, FEV1 and PaO2 when compared to other techniques (CPAP and BiPAP). In another randomized clinical trial [20], the addition of IS to respiratory physiotherapy (DBE, early mobilization and techniques of [20] / 1997/ RCT Matte et al [24] / 2000/ RCT Westerdahl et al [21] / 2001/ RCT Brasher et al [23] / 2003/ RCT Westerdahl et al [28] / 2003/ RCT Pasquina et al [26] / 2004/ RCT Borghi-Silva et al [29] / 2005/ RCT Westerdahl et al [22] / 2005/ RCT Mendes et al [30] / 2006/ RCT Muller et al [25] bronchial hygiene) was not more effective than the respiratory physiotherapy alone in reducing the occurrence of pulmonary complications, the length of hospital stay, radiological pulmonary function or SatO 2 improvement. In the early days of PO HS, the use of such resources was associated with greater difficulty in lung expansion due to restrictive factors such as pain [27], with questionable potential to prevent subsequent damage in lung function [24].…”

Section: Resultsmentioning

confidence: 99%

“…Such methods of ventilation serve to reduce respiratory function and improve respiratory gas exchange [45,46]. Positive effects were observed with the use of NIV, including improvements in BIPP [25,27], BIPP associated with PEP [30], CPAP [24][25][26] and BiPAP [24,26] in the first days after HS, when the breathing is characterized by low tidal volume, offset by increased respiratory rate [24]. The adoption of this pattern of breathing tends to favor the development and continuity of atelectasis and changes in gas exchange [25,26].…”

Section: Resultsmentioning

confidence: 99%

“…The analyzed variables included pulmonary oxygenation (oxygen saturation -SatO 2 , partial pressure of oxygen in arterial blood -PaO 2 , oxygenation index -PaO 2 / FiO 2 ) [20,[22][23][24][25][26][27][28]; lung function measured by spirometry (forced expiratory volume in the first second -FEV1, vital capacity -VC, forced vital capacity -FVC, peak expiratory flow -PEF, forced expiratory flow between 25 and 75% of FVC -FEF 25-75%) [20][21][22]24,26,29,30]; chest x-rays, including signs of atelectasis [20,21,23,24,26]; time of hospital stay [20,23]; rates of lung infection [20.23], respiratory muscle strength (maximum inspiratory pressure -MIP, and maximal expiratory pressure -MEP) [27,29,30]. Two of the included studies analyzed the results of thoracic computed tomography (TCT) [22.28].…”

Section: Variables Analyzedmentioning

confidence: 99%

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Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Renault¹,

Costa-Val²,

Rossetti

2008

Rev Bras Cir Cardiovasc

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The aim of this study is to make a literature review about the different techniques of respiratory physiotherapy used after cardiac surgery and their effectiveness in reverting pulmonary dysfunction. It has been used as reference publications in English and Portuguese using as keywords thoracic surgery, respiratory exercises, physiotherapy modalities, postoperative complications and coronary artery bypass grafting, contained in the following databases -BIREME, SciELO Brazil, LILACS, PUBMED, from 1997 to 2007. A secondary study through list of references of identified articles also was performed. It has been selected eleven randomized trials (997 patients). Among the articles included in this study, incentive spirometry was used in three; deep breathing exercises in six; deep breathing exercises associated with positive expiratory pressure in four and positive expiratory pressure associated with inspiratory resistance in two. Three studies used intermittent positive pressure breathing. Continuous positive airway pressure and bi-level positive airway pressure has been used in three and two studies respectively. The protocols used in the studies were varied and the co-interventions were present in most of them. The different analyzed variables and the time of postoperatory follow-up make a comparative analysis difficult. Pulmonary dysfunction is evident in the postoperatory period of cardiac surgery. The use of non-invasive ventilation has been associated with good results in the first postoperatory days. Despite the known importance of postoperatory respiratory physiotherapy, until now, there is no consensus in the literature about the superiority of one technique over the others. 563RENAULT, JA ET AL -Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery Bras Cir Cardiovasc 2008; 23(4): 562-569 Rev METHODS Search StrategyUsing a primary and secondary search strategy, we performed a literature review of the different techniques of respiratory physiotherapy used in the PO of heart surgery and their effectiveness in the reversion of pulmonary dysfunction, using as publications in English and Portuguese as references. The descriptors used were thoracic surgery, respiratory exercises, physiotherapy modalities, postoperative complications and CABG, and were searched for in the following data sources: BIREME, SciELO Brazil, LILACS and PUBMED from 1997 until 2007. We avoided an excess of similar studies. A secondary search through the considered articles' list of references was also performed. Criteria for the selection of studiesRandomized clinical studies were selected for analysis if they had more than 20 patients and adults who had undergone HS, and if they compared different techniques of respiratory physiotherapy, or if they compared these techniques to procedures without respiratory physiotherapy in the PO. We also selected articles about HS and its pulmonary repercussions in order to introduce the subject and provide a stronger theoretical base. Variables analyzedThe analyzed v...

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Variables Analyzedmentioning

confidence: 99%

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Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Renault¹,

Costa-Val²,

Rossetti

2008

Rev Bras Cir Cardiovasc

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Place de la relaxation de pression en 2013 : du nouveau depuis les JIKRI ?

Riffard

2014

Kinésithérapie, la Revue

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Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson’s disease patients: a randomized trial

Yusuf

Bhise

Nuhmani

et al. 2023

Sci Rep

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Upper airway obstruction, reduced maximal expiratory and inspiratory flows, reduced lung volumes, abnormal ventilatory control, and diaphragmatic dyskinesias are reported in patients with Parkinson’s disease (PD). Inspiratory muscle training (IMT) has been reported to be effective in improving respiratory functions; however, no studies have compared the effects of the incentive spirometer (IS) with the threshold inspiratory muscle trainer (TIMT) in patients with PD. The study aimed to compare the effects of IS and TIMT on maximum inspiratory pressure (MIP), 6-min walk distance (6-MWD), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR) in patients with stage 1–3 according to the Hoehn and Yahr scale. 18 patients were randomly assigned to two groups, i.e., incentive spirometer (IS) and threshold inspiratory muscle trainer (TIMT) group. The IS group received IMT with volume-based IS, and the TIMT group received IMT with TIMT. MIP, 6-MWD, FVC, FEV1, and PEFR were measured before and after six weeks of training. In IS group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 18.13 and 5%, respectively. In the TIMT group: A significant increase (p < 0.05) was observed in MIP and 6-MWD by 30.15 and 8.94%, respectively. Both groups observed no significant difference (p > 0.05) in FVC, FEV1, and PEFR. When the two groups were compared, a greater increase (p < 0.05) was observed in the MIP and 6-MWD in the TIMT group compared to IS group. IMT with IS or TIMT for six weeks effectively increased MIP and 6-MWD in patients with stage 1–3 (Hoehn and Yahr scale) of PD. No improvement was observed in FVC, FEV1, or PEFR with any of the techniques. TIMT is more effective than IS in improving MIP and 6-MWD.

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Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Cited by 25 publications

References 17 publications

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Place de la relaxation de pression en 2013 : du nouveau depuis les JIKRI ?

Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson’s disease patients: a randomized trial

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