The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery

Westerdahl, Elisabeth; Lindmark, Birgitta; Eriksson, Tomas; Hedenstierna, Göran; Tenling, Arne

doi:10.1080/14017430310014984

Cited by 67 publications

(78 citation statements)

References 13 publications

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“…The most common radiological changes observed in the PO is atelectasis [22,26,28,36,37]. These findings were radiologically confirmed [21] by TCT [28], mainly in relation to the left lower lobe.…”

Section: Resultssupporting

confidence: 65%

“…These findings were radiologically confirmed [21] by TCT [28], mainly in relation to the left lower lobe. Atelectasis is related to damage in gas exchange and reduction in lung volumes, and reduces functional residual capacity (FRC) and lung compliance.…”

Section: Resultssupporting

confidence: 64%

“…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 reduction in lung volume and capacity contributes to changes in gas exchange, resulting in hypoxemia [15,17,28,33,35] and decreasing diffusion capacity [21]. Restrictive presentation often persists over more than 116 days [32,36].…”

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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