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Comparison of Lung Expansion Techniques on Thoracoabdominal Mechanics and Incidence of Pulmonary Complications After Upper Abdominal Surgery
- Source :
- Chest. 148:1003-1010
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- OBJECTIVE Lung expansion techniques (LETs) are widely used to prevent postoperative pulmonary complications (PPCs). However, the effects of each of these techniques on thoracoabdominal mechanics and PPC incidence after abdominal surgery remain unclear. The objective of this study was to compare the effects of LET on pulmonary volumes, respiratory muscle activation, and PPC incidence after major, elective upper abdominal surgery. METHODS This randomized controlled trial enrolled 137 patients who were randomly assigned into four groups: control (n = 35), flow incentive spirometry (n = 33), deep breathing (n = 35), and volume incentive spirometry (n = 34). Each intervention was performed tid during 5 consecutive days. Subsequently, PPCs (pneumonia, atelectasis, or severe hypoxemia) were analyzed by a blinded assessor until hospital discharge. Lung volumes (optoelectronic plethysmography) and inspiratory muscular activation (surface electromyography) were assessed before and 3 days after surgery. Intention-to-treat analysis was performed. RESULTS Before surgery, all groups were homogenous for age, sex, BMI, lung function, and thoracoabdominal mechanics. After surgery, no difference was observed in the lung volumes and inspiratory muscular activation during the lung expansion technique (P ≥ .05). The PPC incidence was higher in the deep breathing group (P CONCLUSIONS LETs do not modify the changes on thoracoabdominal mechanics or prevent PPCs after abdominal surgery. The indiscriminate use of LETs should not be routinely prescribed to prevent PPCs; however, more studies are required to confirm our results and to change the standard practice. TRIAL REGISTRY ClinicalTrials.gov ; No.: NCT01993602; URL: www.clinicaltrials.gov
- Subjects :
- Pulmonary and Respiratory Medicine
Spirometry
medicine.medical_specialty
Lung
medicine.diagnostic_test
business.industry
Diaphragmatic breathing
Atelectasis
Mechanics
Critical Care and Intensive Care Medicine
medicine.disease
Surgery
law.invention
medicine.anatomical_structure
Randomized controlled trial
law
Anesthesia
medicine
Respiratory muscle
Lung volumes
Cardiology and Cardiovascular Medicine
business
Abdominal surgery
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 148
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi...........c9eea637a20cbf606ac1fe6e78984fa1