Evaluation of breathing exercise in hormonal and immunological responses in patients undergoing abdominal surgery

Abstract

PURPOSE:To evaluate the effects of sustained deep inspiration in the prevention of postoperative pulmonary complications, the hormonal and immunological responses in patients submitted to abdominal surgery. METHODS:This randomized clinical trial study included 75 patients submitted to abdominal surgery, of which 36 were randomly allocated in the experimental group and underwent sustained deep inspiration during five seconds, in three sets of ten repetitions per day.The others 39 patients were allocated in the control group and were not submitted to any breathing exercise. The following parameters were measured preoperatively, 24h and 48h postoperatively: chest x-ray, serum ACTH, cortisol, IL-4, IL-10, TNF-α, forced expiratory volume in first second (FEV1), forced expiratory flow 25-75% (FEF 25-75), forced vital capacity (FVC), paO 2 and paCO 2 . RESULTS:Mean serum cortisol in patients of the experimental and control groups before surgery were 12.8 mcg/dl (4.6-50) and 10.48 mcg/dl (1-29.1), respectively (p=0.414). The experimental group had significantly increase in serum cortisol levels, 23.6 mcg/dl (9.3-45.8), especially 24h postoperatively (p=0.049). CONCLUSION:Sustained deep inspiration in patients submitted to abdominal surgery determined important changes in serum cortisol, however, without significantly influence the postoperative pulmonary complications and the endocrine and immune responses.

Breathing exercises: influence on breathing patterns and thoracoabdominal motion in healthy subjects

“…Next, the participants learned the following breathing exercises which were randomized (computer program): diaphragmatic breathing - the participants had to perform a slow and deep nasal inspiration emphasizing the anterior displacement of the abdomen and avoiding RC displacement 4 , 22 ; inspiratory sighs - short, successive, and slow nasal inspirations until the inspiratory capacity was reached 7 ; sustained maximal inspiration - a slow nasal maximal inspiratory effort to reach the inspiratory capacity, followed by a 3-second post-inspiratory pause 23 ; and intercostal breathing - nasal inspiration emphasizing the displacement of the upper portion of the thorax 9 . For the diaphragmatic breathing, inspiratory sighs, and maximal inspiration, the subjects were instructed to perform a smooth and controlled pursed lip expiration.…”

Improvement in Lung Insufflation in Spontaneously Breathing Tracheostomized Patients by Using a New Pulmonary Expansion Device: A Pilot Study

“…Breathing exercises consisted of diaphragmatic breathing in which the patient performed a deep inspiration emphasizing the anterior displacement of the abdomen and avoiding rib cage displacement [16]. Later, patients were encouraged to perform short, successive, and slow inspirations until reaching maximal inspiratory capacity; finally, they were asked to perform a sustained maximal inspiration consistent in a maximal inspiratory effort to attain the inspiratory capacity, followed by a 5-s postinspiratory pause [17]. For each series of diaphragmatic breathing, short inspirations, and maximal inspiration, participants were instructed to perform a smooth and controlled expiration, according to previous publications [16].…”