Randomized Controlled Trial of Physiotherapy for Postoperative Pulmonary Complications

Abstract

A prospective randomized controlled trial was conducted in patients undergoing elective cholecystectomy to assess the value of routine chest physiotherapy. One hundred and two patients entered the study: 47 patients developed no pulmonary complications, 29 had pulmonary atelectasis and a further 26 developed chest infection. The pattern of changes in anerial oxygen tension in the period after operation supponed the Hiniral allocation of the patients. Of 51 patients not receiving physiotherapy, 11 developed atelectasis and 19 chest infection. Of 51 treated patients, 18 developed atelectasis and seven chest infection. Routine prophylactic postoperative chest physiotherapy decreased significantly the frequency of chest infection (P< 0.02). PATIENTS AND METHODS Consecutive patients undergoing elective cholecystectomy were included in the study. Respiratory status was established before operation using a ques

Postoperative study of vital capacity and ventilation measurements following elective craniotomy

“…5,21,[29][30][31][32][33] Thus, in view of the susceptibility of this group of patients to the development of postoperative respiratory complications, the indication of physiotherapy before and after the operation is justified, since several studies have confirmed the efficiency of such treatment for reducing pulmonary complications in patients undergoing abdominal surgery. [34][35][36][37] CONCLUSIONS In summary, the present study showed that, among patients undergoing craniotomy, VC and TV are lowered at least up to the fourth postoperative day and VE is lowered up to the second postoperative day. Surgery duration of more than four hours for patients undergoing craniotomy because of aneurysms caused a greater decrease in VC and TV than seen among patients whose surgery lasted for less than four hours.…”

Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery

“…Many studies have demonstrated the effectiveness of chest physiotherapy 3,[13][14][15][16][17][18]20,[22][23][24][25][26][27][28][29][30] . However, only a few have had an untreated control group 3,14,[16][17][18] . The present study indicates that chest physiotherapy given to patients before major abdominal surgery effectively reduces the risk of postoperative pulmonary complications.…”

“…However, the clinical benefit of chest physiotherapy is controversial. In 1954 Thorén 3 reported in a controlled trial that the incidence of pulmonary complications after gallbladder surgery decreased with chest physiotherapy whereas Morran et al 14 concluded in 1983 that chest physiotherapy caused more atelectasis but fewer chest infections. No difference in the rate of pulmonary complications was noted in a study that compared two groups of low-risk patients treated before and/or after operation 15 .…”

“…No difference in the rate of pulmonary complications was noted in a study that compared two groups of low-risk patients treated before and/or after operation 15 . Few studies are prospective and have an untreated control group 3,14,[16][17][18] . These studies have compared patients after low-risk surgery 3,14,17,18 or have not separated patients at low risk from those at high risk 16 .…”

The Scientific Basis for Postoperative Respiratory Care

“…Of the 51 patients who received CPT, 18 developed atelectasis and 7 chest infection. The authors concluded that routine prophylactic postoperative CPT significantly reduced the incidence of postoperative chest infection, 80 Torrington et al compared traditional postoperative therapy with and without CPT in a group of 52 morbidly obese subjects following gastric bypass, and concluded that CPT caused patient discomfort, increased hospital cost, and failed to alter the incidence of PPCs. 81 Christensen and colleagues 82 studied 3 postoperative regimens of respiratory therapy on PPCs and lung function in high-risk patients.…”