Fewer lung complications following inspiratory muscle training in patients undergoing coronary bypass surgery: a randomized trial

The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG). Randomized...

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Bibliographic Details
Published in:	Nederlands tijdschrift voor geneeskunde Vol. 151; no. 45; p. 2505
Main Authors:	Hulzebos, E H J, Helders, P J M, Favié, N J, de Bie, R A, Brutel de la Rivière, A, van Meeteren, N L U
Format:	Journal Article
Language:	Dutch
Published:	Netherlands 10-11-2007
Subjects:	Aged Breathing Exercises Coronary Artery Bypass Cough Female Humans Length of Stay Male Pleural Effusion - etiology Pleural Effusion - prevention & control Pneumonia - etiology Pneumonia - prevention & control Pneumothorax - etiology Pneumothorax - prevention & control Postoperative Complications - etiology Postoperative Complications - prevention & control Preoperative Care Respiratory Function Tests Respiratory Tract Diseases - etiology Respiratory Tract Diseases - prevention & control Risk Assessment Single-Blind Method
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Summary:	The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG). Randomized controlled clinical trial (www.controlled-trials. com/isrctn17691887). Of 655 patients referred to a university medical centre in The Netherlands for elective CABG, 299 met the criteria for being at high risk of developing PPCs. A total of 279 were enrolled and monitored up to discharge from hospital. Patients were randomly assigned to receive either preoperative IMT (n=140) or usual care (n=139). Both groups received the same postoperative treatment. Both groups were comparable at baseline. Before CABG, 2 control group patients and 1 IMT group patient died. After CABG surgery, PPCs were present in 25 (18%) of 139 patients in the IMT group and 48 (35%) of 137 patients in the control group (OR: 0.52; 95% CI: 0.30-0.92). Pneumonia occurred in 9 (6.5%) of 139 patients in the IMT group and in 22 (16.1%) of 137 patients in the usual care group (OR: 0.40; 95% CI: 0.19-0.84). Mean duration of postoperative hospitalization was 7 (range 5-41) days in the IMT group versus 8 (range 6-70) days in the usual care group (Mann-Whitney test; Z: -2.42; p = 0.015). Preoperative physiotherapy, including IMT, statistically significantly reduced the incidence ofPPCs and the duration ofpostoperative hospitalization in patients at high risk of developing a pulmonary complication on undergoing CABG.
ISSN:	0028-2162