Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy

Lunardi, Adriana Cláudia; Cecconello, Ivan; Carvalho, Celso Ricardo Fernandes

doi:10.1590/s1413-35552011000200012

Cited by 24 publications

(15 citation statements)

References 26 publications

(26 reference statements)

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“…This finding was agreed byLunardi et.al, (2010) (76) who concluded that postoperative inspiratory muscle training reduced the rate of respiratory complications, thoracic drainage time, the need to return to mechanical ventilation and the need for chest tube re-insertion.…”

Section: Effect Of Inspiratory Muscle Training Onsupporting

confidence: 83%

“…The finding of the current study was in handwithLunardi et.al, (2010) (76) who stated that re-intubation for respiratory failure was lower in the study group than in control group. In contrast, the findings of the current study were contradicted by Elkins et.al, (2105) (70) who found that no statistical significant difference found between the two groups in relation to the need for re-intubation.…”

Section: Effect Of Inspiratory Muscle Training Onsupporting

confidence: 82%

See 1 more Smart Citation

Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries

Eleter¹,

Basal²,

El-Azazy³

et al. 2016

IOSR

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Section: Effect Of Inspiratory Muscle Training Onsupporting

confidence: 83%

Section: Effect Of Inspiratory Muscle Training Onsupporting

confidence: 82%

Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries

Eleter¹,

Basal²,

El-Azazy³

et al. 2016

IOSR

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“…Despite this, there are limited studies which look for a direct association between the use of physiotherapy and the prevention of respiratory complications following esophagectomy. One retrospective study did identified lower rates of respiratory complications in those patients receiving postoperative physiotherapy …”

Section: Approaches To Reducing Pulmonary Morbidity After Esophagectomymentioning

confidence: 99%

Pathophysiology of acute lung injury following esophagectomy

2014

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KEY WORDS: acute lung injury, acute respiratory distress syndrome, esophagectomy, pathophysiology, postoperative complications.Esophagectomy is widely considered to be a high risk surgical approach. While improvements in surgical technique, perioperative monitoring, and postoperative care have led to a reduction in mortality following esophagectomy, early mortality remains between 5% and 10%. 1,2 Moreover, postoperative complications, involving predominantly the cardiorespiratory system, occur in up to 50% of patients. 3 Of the numerous respiratory complications that are associated with esophagectomy, acute lung injury (ALI) and its more severe form acute respiratory distress syndrome (ARDS) are of notable significance due to their prevalence and impact on early morbidity and mortality. 4 Reported rates of ALI and ARDS following esophagectomy are 23.8% and 14.5% respectively, the latter associated with 50% mortality. 4 While the existence of an accepted clinical definition for ALI/ARDS 5 has greatly contributed to the wider study of ALI/ARDS, continued variability in reporting practices has meant that the pathophysiology of this syndrome in the context of esophagectomy remains incompletely understood. Notwithstanding, patient-specific factors, the extent and nature of surgical trauma, and frequent requirement for periods of one-lung ventilation (OLV) are all anticipated to contribute to the development of ALI/ARDS following esophagectomy through their influence on systemic and local inflammatory responses. Consequently, the aim of this review is to define the pathophysiology of ALI/ARDS in the setting of esophagectomy and to explore potential strategies for prediction and prevention of this complication. PATHOPHYSIOLOGY OF ALI/ARDSAs first described by Ashbaugh et al. in 1967, ALI/ ARDS is recognized as a constellation of clinical, radiological, and physical abnormalities that collectively define an underlying picture of diffuse damage to the alveolar capillary unit and associated pulmonary gas exchange disturbance. 6 Central to this process is disruption of vascular endothelial and pulmonary epithelial linings and subsequent flooding of the alveolar and interstitial spaces with proteinaceous fluid, rich in inflammatory mediations and leukocytes. 7 Causes of ALI/ARDS can be broadly divided between those that result in either direct or indirect lung injury. Common sources of direct lung injury include: pneumonia, aspiration, trauma, reperfusion, and inhalation injury. Alternatively, sepsis, shock, polytrauma, and blood transfusion are common sources of indirect lung injury. 8 In patients undergoing esophagectomy precipitants of ALI/ARDS may reflect both local and systemic insults.

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“…Lunardi et al found that PPC after oesophagectomy are reduced in patients who had undergone chest PT before surgery. Nevertheless the hospital length of stay did not differ in patients treated with PT compared to control patients [42]. Several reviews evaluated the potential effects of chest PT in the pre- and post-operative time.…”

Section: Abdominal Surgerymentioning

confidence: 99%

Peri-operative physiotherapy

Makhabah¹,

Martino²,

Ambrosino

2013

Multidisciplinary Respiratory Medicine

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Postoperative pulmonary complications (PPC) are a major cause of morbidity, mortality, prolonged hospital stay, and increased cost of care. Physiotherapy (PT) programs in post-surgical and critical area patients are aimed to reduce the risks of PPC due to long-term bed-rest, to improve the patient’s quality of life and residual function, and to avoid new hospitalizations. At this purpose, PT programs apply advanced cost-effective therapeutic modalities to decrease complications and patient’s ventilator-dependency. Strategies to reduce PPC include monitoring and reduction of risk factors, improving preoperative status, patient education, smoking cessation, intra-operative and postoperative pulmonary care. Different PT techniques, as a part of the comprehensive management of patients undergoing cardiac, upper abdominal, and thoracic surgery, may prevent and treat PPC such as secretion retention, atelectasis, and pneumonia.

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Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy

Abstract: Background: Esophagectomy presents the highest rate of postoperative pulmonary complications among all types of upper abdominal

Cited by 24 publications

References 26 publications

Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries

Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries

Pathophysiology of acute lung injury following esophagectomy

Peri-operative physiotherapy

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