The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study

Shahood, Hadel; Pakai, A; Kiss, Rudolf; Bory, Eva; Szilágyi, N; Sandor, Adrienn; Verzár, Zsófia

doi:10.5144/0256-4947.2022.8

Cited by 12 publications

(8 citation statements)

References 46 publications

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“…The recently published work of our group showed supporting findings [42]. Our RCT demonstrated overall significant postoperative improvements in lung function and oxygen saturation in the intervention group compared with the control group.…”

Section: Discussionsupporting

confidence: 86%

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

et al. 2022

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Background and Objectives: Patients undergoing cardiac surgery are particularly vulnerable for developing postoperative pulmonary complications (PPCs). This systematic review and meta-analysis aimed to evaluate the role of preoperative chest physiotherapy in such patients. Materials and Methods: All original articles that assessed patients undergoing elective cardiac surgery, with preoperative chest physiotherapy, and compared them to patients undergoing elective cardiac surgery, without preoperative chest physiotherapy, were included. Animal studies, studies conducted prior to the year 2000, commentaries, or general discussion papers whose authors did not present original data were excluded. Studies assessing physiotherapy regimens other than chest physiotherapy were also excluded. The search was performed using the following electronic resources: the Cochrane Central Register of Controlled Trials, the PubMed central database, and Embase. The included studies were assessed for potential bias using the Cochrane Collaboration’s tool for assessing the risk of bias. Each article was read carefully, and any relevant data were extracted. The extracted data were registered, tabulated, and analyzed using Review Manager software. Results: A total of 10 articles investigating 1458 patients were included in the study. The studies were published from 2006 to 2019. The populations were patients scheduled for elective CABG/cardiac surgery, and they were classified into two groups: the interventional (I) group, involving 651 patients, and the control (C) group, involving 807 patients. The meta-analysis demonstrated no significant differences between the interventional and control groups in surgery time and ICU duration, but a significant difference was found in the time of mechanical ventilation and the length of hospital stay, favoring the interventional group. A significant difference was shown in the forced expiratory volume in 1s (FEV1% predicted), forced vital capacity (FVC% predicted), and maximum inspiratory pressure (Pi-max), favoring the interventional group. Conclusions: This study is limited by the fact that one of the included ten studies was not an RCT. Moreover, due to lack of the assessment of certain variables in some studies, the highest number of studies included in a meta-analysis was the hospital stay length (eight studies), and the other variables were analyzed in a fewer number of studies. The data obtained can be considered as initial results until more inclusive RCTs are conducted involving a larger meta-analysis. However, in the present study, the intervention was proved to be protective against the occurrence of PPCs. The current work concluded that preoperative chest physiotherapy can yield better outcomes in patients undergoing elective cardiac surgery.

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Section: Discussionsupporting

confidence: 86%

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

et al. 2022

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“…positive effect on reducing HLOS, supporting this conclusion, multiple clinical trials have demonstrated that preoperative respiratory physiotherapy utilizing various maneuvers is effective in reducing hospitalization for patients undergoing cardiac surgeries. [28][29][30][31]…”

Section: Originalmentioning

confidence: 99%

Preoperative Incentive Spirometer to Prevent Postoperative Pulmonary Complications following Open Heart Surgeries: A Randomized Single Blinded Multi-Centric Clinical Trial

Faleh

AL-Fayyadh

2022

J. Contemp. Med. Sci.

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Objectives: To determine the effect preoperative use of an Incentive Spirometer (IS) has on preventing postoperative pulmonary complications among patients undergoing open heart surgeries. Methods: A prospective, randomized, controlled single-blinded parallel-group design. Data were collected from January 9th 2022 to April 1st 2022. A total of n = 64 eligible patients were equally randomized to either intervention or control group. Patients in the intervention group performed preoperative IS training for two days before the scheduled surgery. The primary endpoint was the incidence of in-hospital PPCs. The secondary endpoints were postoperative Peak Expiratory Flow Rate (PEFR), Intensive Care Unit (ICU) stay, Hospital Length of Stay (HLOS). Results: Patients in the intervention group had a lower incidence of postoperative pulmonary complications compared to the control group (12.5% and 21.8%). There was a statistical significant difference between the two groups regarding postoperative PEFR, HLOS and intensive care unit stay. Conclusions: Preoperative rehabilitation (involving incentive spirometer is related to a lower incidence of postoperative pulmonary complications for the group that received the intervention. Training with preoperative incentive spirometer resulted in a shortening of hospital length of stay and Intensive Care Unit (ICU) stay. Trial registration: The study was registered in the Iranian Clinical Trial Registry, this at https://www.irct.ir/ reference number (IRCT20211224053503N1).

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“…To assess the effect of preoperative home chest physiotherapy program for one week on oxygenation and lung function. Shahood et al (2022) (21) conducted a randomized controlled trial included 100 patients undergoing open heart surgery (46 in the intervention group, 54 in the control group). The primary outcomes were the differences in respiratory function parameters and oxygen saturation.…”

Section: -Randomized Controlled Trialsmentioning

confidence: 99%

Preoperative Pulmonary Rehabilitation to Prevent Postoperative Pulmonary Complications following Open Heart Surgery: A Narrative Review

Noor¹,

AL-Fayyadh²

2022

Kufa Jour. Nurs. Sci.

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Background: Numerous medical disciplines have recognized the preoperative period as a crucial phase to enhance patient recovery and outcomes. Patients perform preoperative pulmonary rehabilitation with inspiratory or expiratory muscle training to enhance lung protection. Despite the variety of breathing techniques in the clinical setting, the literature lacks a conclusive evidence regarding which technique is more effective. Research question: In adult patients undergoing open heart surgeries, is preoperative pulmonary rehabilitation of benefit in preventing postoperative pulmonary complications, shorten length of stay in the intensive care unit (ICU) or hospital? Methods: The authors conducted a search in electronic databases regarding the current evidence of preoperative pulmonary rehabilitation. Subjects: Patients undergoing Coronary Artery Bypass Grafts (CABG) and/or valvular surgery. Intervention: Any pulmonary intervention, such as incentive spirometer, inspiratory muscle training, exercise training or relaxation, delivered prior to surgery, single or combined. Outcome measures: The incidence of persistent post-concussion symptoms (PPCSs), pulmonary function test (PFT), ventilation period, length of stay in ICU and hospital Results: The authors conducted an initial search in the systematic reviews, which yielded 16 published articles. Furthermore, the authors search in the randomized controlled trials and this yielded 72 articles. The relevancy of the selected publications was determined by reviewing their titles, keyword, and abstracts. Overall a total of eight randomized controlled trials (RCTs) and six systematic reviews involving 3908 participants were included in this review. Conclusion: Preoperative pulmonary rehabilitation utilizing various breathing techniques reduces the incidence of postoperative pulmonary complications. Keywords Preoperative Care, Breathing Exercises, Postoperative Complications, Coronary Artery Bypass, Cardiac Surgery.

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The effect of preoperative chest physiotherapy on oxygenation and lung function in cardiac surgery patients: a randomized controlled study

Cited by 12 publications

References 46 publications

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

Preoperative Incentive Spirometer to Prevent Postoperative Pulmonary Complications following Open Heart Surgeries: A Randomized Single Blinded Multi-Centric Clinical Trial

Preoperative Pulmonary Rehabilitation to Prevent Postoperative Pulmonary Complications following Open Heart Surgery: A Narrative Review

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