The Effectiveness of Incentive Spirometry With Physical Therapy for High-Risk Patients After Coronary Artery Bypass Surgery

Crowe, Jean; Bradley, Christine A.

doi:10.1093/ptj/77.3.260

Cited by 70 publications

(82 citation statements)

References 20 publications

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“…Findings on pleural effusion are also frequent. It was found at a rate of 32% and 43.9% on the 2 nd and 3 rd postoperative day (POD), respectively [20]. Westerdahl et al [21] found it in 63% of patients on the 4 th POD, data similar to the study of Vargas et al [38], on which the authors used TCT as preliminary tool.…”

Section: Resultsmentioning

confidence: 63%

“…Lung infections, whose prevalence ranges between 3.5% [23] and 10% [20], also contribute to the morbidity related to HS. Westerdahl et al [22] found no signs of lung infection in any of the patients the authors included.…”

Section: Resultsmentioning

confidence: 99%

“…All trials included had samples larger than 20 patients. 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].…”

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%

“…Moreover, median sternotomy contributes to threats to the patient's condition, because it reduces the stability and complacency of the chest wall [13][14][15]. In this context, PO pain and the presence of drains are directly involved in the maintenance of low lung volumes [16][17][18][19][20].…”

Section: Introductionmentioning

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: 63%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Variables Analyzedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Renault¹,

Costa-Val²,

Rossetti

2008

Rev Bras Cir Cardiovasc

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Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG Surgery

Hulzebos

Helders²,

Favié³

et al. 2006

JAMA

586

477

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Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft

Freitas¹,

Soares²,

Cardoso³

et al. 2007

Cochrane Database of Systematic Reviews

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Individual small trials suggest that there is no evidence of benefit from incentive spirometry in reducing pulmonary complications and in decreasing the negative effects on pulmonary function in patients undergoing CABG. In view of the modest number of patients studied, methodological shortcomings and poor reporting of the included trials, these results should be interpreted cautiously. An appropriately powered trial of high methodological rigour is needed to determine those patients who may derive benefit from incentive spirometry following CABG.

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The Effectiveness of Incentive Spirometry With Physical Therapy for High-Risk Patients After Coronary Artery Bypass Surgery

Cited by 70 publications

References 20 publications

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Fisioterapia respiratória na disfunção pulmonar pós-cirurgia cardíaca

Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG Surgery

Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft

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