Background:
Bariatric surgery can trigger postoperative pulmonary complications due to
factors inherent to the procedure, mainly due to diaphragmatic dysfunction.
Aim:
To evaluate and compare the effects of two levels of positive pressure and
exercises with inspiratory load on lung function, inspiratory muscle
strength and respiratory muscle resistance, and the prevalence of
atelectasis after gastroplasty.
Methods:
Clinical, randomized and blind trial, with subjects submitted to bariatric
surgery, allocated to two groups: positive pressure group, who received
positive pressure at two levels during one hour and conventional respiratory
physiotherapy and inspiratory load group, who performed exercises with load
linear inspiratory pressure, six sets of 15 repetitions, in addition to
conventional respiratory physiotherapy, both of which were applied twice in
the immediate postoperative period and three times a day on the first
postoperative day. Spirometry was performed for pulmonary function analysis,
nasal inspiratory pressure for inspiratory muscle strength and incremental
test of respiratory muscle resistance for sustained maximal inspiratory
pressure, both preoperatively and on hospital discharge on the second
postoperative day.
Results:
There was no significant difference (p> 0.05) in the expiratory reserve
volume and in the tidal volume in the pre and postoperative periods when
compared intra and intergroup. There was no significant difference
(p>0.05) in the nasal inspiratory pressure and the maximal inspiratory
pressure maintained in the inspiratory load group in the intragroup
evaluation, but with a significant difference (p<0.05) compared to the
positive pressure group. The prevalence of atelectasis was 5% in both groups
with no significant difference (p>0.05) between them.
Conclusion:
Both groups, associated with conventional respiratory physiotherapy,
preserved expiratory reserve volume and tidal volume and had a low
atelectasis rate. The inspiratory loading group still maintained inspiratory
muscle strength and resistance of respiratory muscles.