Inspirometria de incentivo e breath stacking: repercussões sobre a capacidade inspiratória em indivíduos submetidos à cirurgia abdominal

Dias, Claudia Mazza; Plácido, TR; Mfb, Ferreira; Guimarães, F.S.; Menezes, Sara L. S.

doi:10.1590/s1413-35552008000200004

Cited by 25 publications

(40 citation statements)

References 29 publications

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“…This is consistent with our previous findings when evaluating abdominal surgery patients. (25) As previously described, high inspiratory volume is essential to the effectiveness of cough. Improvements in cough PEF can be achieved when cough is started from the maximal inspiratory volume in normal subjects, in patients with neuromuscular disease, (26) and in postoperative patients.…”

Section: Discussionmentioning

confidence: 89%

Três protocolos fisioterapêuticos: efeitos sobre os volumes pulmonares após cirurgia cardíaca

Dias¹,

Vieira

Oliveira

et al. 2011

J. bras. pneumol.

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Objective: To evaluate inspiratory volume in patients undergoing cardiac surgery and to determine the effects that incentive spirometry (IS) and the breath stacking (BS) technique have on the recovery of FVC in such patients. Methods: A prospective, controlled, randomized clinical trial involving 35 patients undergoing cardiac surgery at the Hospital de Força Aérea do Galeão (HFAG, Galeão Air Force Hospital), in the city of Rio de Janeiro, Brazil. The patients, all of whom performed mobilization and cough procedures, were randomly divided into three groups: exercise control (EC), performing only the abovementioned procedures; IS, performing the abovementioned procedures and instructed to take long breaths using an incentive spirometer; and BS, performing the abovementioned procedures, together with successive inspiratory efforts using a facial mask coupled to a unidirectional valve. Forced spirometry was carried out in the preoperative period and on postoperative days 1 to 5. During the maneuvers, inspiratory volume was measured in the IS and BS groups. ResumoObjetivo: Avaliar o volume inspiratório e os efeitos da espirometria de incentivo (EI) e da técnica breath stacking (BS) sobre a CVF em pacientes submetidos a cirurgia cardíaca. Métodos: Estudo prospectivo controlado e randomizado com 35 pacientes submetidos a cirurgia cardíaca no Hospital de Força Aérea do Galeão, Rio de Janeiro (RJ). Todos os pacientes realizaram procedimentos de mobilização e tosse e foram randomicamente alocados em três grupos: grupo exercício controle (EC), que realizou somente esses procedimentos; grupo EI, que realizou inspirações profundas utilizando um espirômetro de incentivo; e grupo BS, que realizou esforços inspiratórios sucessivos utilizando uma máscara facial acoplada a uma válvula unidirecional. A espirometria forçada foi realizada no período pré-operatório e do primeiro ao quinto dia de pós-operatório. O volume inspiratório foi medido durante as manobras nos grupos EI e BS. Resultados: No primeiro dia de pós-operatório, a CVF diminuiu significativamente em todos os grupos (EC: 87,1 vs. 32,0%; EI: 75,3 vs. 29,5%; e BS: 81,9 vs. 33,2%; p < 0.001 para todos) assim como o volume inspiratório nos grupos EI e BS (EI: 2,29 vs. 0,82 L; e BS: 2,56 vs. 1,34 L, p < 0.001 para ambos). Do primeiro ao quinto dia de pós-operatório, a CVF apresentou recuperação parcial independentemente do protocolo (EC: 32,0 vs. 51,3%; EI: 29,5 vs. 46,7%; e BS: 33,3 vs. 54,3%; p < 0.001 para todos). Durante o período pós-operatório avaliado, o volume inspiratório foi significativamente maior no grupo BS do que no EI. Conclusões: Os protocolos foram equivalentes no que se refere à recuperação da CVF nos primeiros cinco dias de pós-operatório. Quando comparada à EI, a técnica BS promoveu maiores volumes inspiratórios nesta amostra de pacientes submetidos à cirurgia cardíaca.

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Section: Discussionmentioning

confidence: 89%

Três protocolos fisioterapêuticos: efeitos sobre os volumes pulmonares após cirurgia cardíaca

Dias¹,

Vieira

Oliveira

et al. 2011

J. bras. pneumol.

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“…(1-4) The Third Brazilian Consensus on Mechanical Ventilation complements these findings by stating that atelectasis occurs in dependent areas immediately after the establishment of general anesthesia. (11) These complications are mainly related to decreased mucociliary clearance, (14) decreased lung volume and alveolar collapse.…”

Section: Discussionmentioning

confidence: 99%

“…(1) However, the effects of this technique on respiratory mechanics in patients with severely impaired lung function must still be evaluated, which may contribute to important decisions in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis between the alveolar recruitment maneuver and breath stacking technique in patients with acute lung injury

Pôrto¹,

Tavolaro²,

Kümpel³

et al. 2014

Revista Brasileira De Terapia Intensiva

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Objective To compare the effectiveness of the alveolar recruitment maneuver and the breath stacking technique with respect to lung mechanics and gas exchange in patients with acute lung injury. Methods Thirty patients were distributed into two groups: Group 1 - breath stacking; and Group 2 - alveolar recruitment maneuver. After undergoing conventional physical therapy, all patients received both treatments with an interval of 1 day between them. In the first group, the breath stacking technique was used initially, and subsequently, the alveolar recruitment maneuver was applied. Group 2 patients were initially subjected to alveolar recruitment, followed by the breath stacking technique. Measurements of lung compliance and airway resistance were evaluated before and after the use of both techniques. Gas analyses were collected before and after the techniques were used to evaluate oxygenation and gas exchange. Results Both groups had a significant increase in static compliance after breath stacking (p=0.021) and alveolar recruitment (p=0.03), but with no significant differences between the groups (p=0.95). The dynamic compliance did not increase for the breath stacking (p=0.22) and alveolar recruitment (p=0.074) groups, with no significant difference between the groups (p=0.11). The airway resistance did not decrease for either groups, i.e., breath stacking (p=0.91) and alveolar recruitment (p=0.82), with no significant difference between the groups (p=0.39). The partial pressure of oxygen increased significantly after breath stacking (p=0.013) and alveolar recruitment (p=0.04), but there was no significant difference between the groups (p=0.073). The alveolar-arterial O2 difference decreased for both groups after the breath stacking (p=0.025) and alveolar recruitment (p=0.03) interventions, and there was no significant difference between the groups (p=0.81). Conclusion Our data suggest that the breath stacking and alveolar recruitment techniques are effective in improving the lung mechanics and gas exchange in patients with acute lung injury.

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“…[6][7][8][9][10][23][24][25][26][27][28][29][30] Contudo, ainda não está totalmente esclarecido se um destes procedimentos cirúrgicos interfere mais do que o outro na mobilidade diafragmática e toracoabdominal do indivíduo.…”

Section: Discussionunclassified

Effects of laparotomy or laparoscopicprocedures for cholecystectomy on diaphragmatic and thoracoabdominal mobility

Pedrini¹,

Saltiél²,

Gonçalves³

et al. 2016

Medicina (Ribeirão Preto)

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Design of the study: Observational descriptive and cross sectional study. Objective: To verify the effects of laparotomy or laparoscopicprocedures for cholecystectomy on lung function, diaphragmatic and thoracoabdominal mobility. Methods: We evaluated 18 individuals who underwent cholecystectomy by either laparotomy (CLG n=9) or by a laparoscopic procedure (LCG, n=9). The participants were evaluated in preoperative and in the 2nd postoperative day: anthropometrics measures, cardiorrespiratory parameters, intensity of pain, pulmonary function, diaphragmatic mobility and thoracoabdominal mobility. For statistical analysis, the Wilcoxon test was applied to compare the pre and postoperative of both groups, Mann-Whitney test was applied to comparison between groups (p≤0.05). Results: Diaphragmatic mobility was reduced in both groups whereas thoracoabdominal mobitity al all levels were reduced only in CLG (p<0.05). In LCG, there was a significant decrease of thoracoabdominal mobility only in the umbilical region (p<0.008). By comparing the values of thoracoabdominal mobility between groups postoperatively, there was a difference only in umbilical mobility (p=0.02). We found a significant reduction in vital capacity (VC) in LCG only (p=0.05). Conclusion: Laparotomy and laparoscopic procedures for cholecystectomy reduce the mobility of the diaphragm, but only laparotomy impairs thoracoabdominal mobility in the three levels, axillary, xiphoid and umbilical

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Inspirometria de incentivo e breath stacking: repercussões sobre a capacidade inspiratória em indivíduos submetidos à cirurgia abdominal

Cited by 25 publications

References 29 publications

Três protocolos fisioterapêuticos: efeitos sobre os volumes pulmonares após cirurgia cardíaca

Três protocolos fisioterapêuticos: efeitos sobre os volumes pulmonares após cirurgia cardíaca

Comparative analysis between the alveolar recruitment maneuver and breath stacking technique in patients with acute lung injury

Effects of laparotomy or laparoscopicprocedures for cholecystectomy on diaphragmatic and thoracoabdominal mobility

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