Effectiveness of preoperative breathing exercise interventions in patients undergoing cardiac surgery: A systematic review

Rodrigues, Soraia Nicola; Henriques, Helga Rafael; Henriques, Maria Adriana

doi:10.1016/j.repc.2020.08.013

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…Nine systematic reviews (Alshewaier et al, 2017, Blasco et al, 2021, Fenton et al, 2021, Husted et al, 2020, Katsura et al, 2015, Potts et al, 2022, Rodrigues et al, 2021, Wang et al, 2021, Wang et al, 2016) provided evidence on the effectiveness of preoperative exercise interventions on improving outcomes of patients awaiting elective surgery. Six of the systematic reviews focussed on orthopaedic surgical procedures (three total knee replacement/arthroplasty, two anterior cruciate ligament reconstruction, and one on both total knee replacement and total hip replacement); two systematic reviews on cardiac and abdominal surgery, and one on cardiac surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Six of the systematic reviews focussed on orthopaedic surgical procedures (three total knee replacement/arthroplasty, two anterior cruciate ligament reconstruction, and one on both total knee replacement and total hip replacement); two systematic reviews on cardiac and abdominal surgery, and one on cardiac surgery. With regards to interventions, three of the nine systematic reviews examining the evidence of exercised-based interventions, were focussed specifically on preoperative rehabilitation (prehabilitation) (Alshewaier et al, 2017, Fenton et al, 2021, Wang et al, 2016); two systematic reviews focused on preoperative inspiratory muscle training (IMT) (Katsura et al, 2015, Rodrigues et al, 2021), and one systematic review focused on sensorimotor training (Blasco et al, 2021). The remaining three systematic reviews focussed on preoperative strength based exercises (Husted et al, 2020, Potts et al, 2022, Wang et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

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A rapid review of the effectiveness of innovations to support patients on elective surgical waiting lists

Okolie

Rodriǵuez

Wale

et al. 2022

Preprint

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Surgical waiting times have reached a record high, in particular with elective and non-emergency treatments being suspended or delayed during the COVID-19 pandemic. Prolonged waits for surgery can impact negatively on patients who may experience worse health outcomes, poor mental health, disease progression, or even death. Time spent waiting for surgery may be better utilised in preparing patients for surgery. This rapid review sought to identify innovations to support patients on surgical waiting lists to inform policy and strategy to address the elective surgical backlog in Wales. The review is based on the findings of existing reviews with priority given to robust evidence synthesis using minimum standards (systematic search, study selection, quality assessment, and appropriate synthesis). The search dates for prioritised reviews ranged from 2014-2021. Forty-eight systematic reviews were included. Most available evidence is derived from orthopaedic surgery reviews which may limit generalisability. The findings show benefits of exercise, education, smoking cessation, and psychological interventions for patients awaiting elective surgery. Policymakers, educators, and clinicians should consider recommending such interventions to be covered in curricula for health professionals. Further research is required to understand how various patient subgroups respond to preoperative interventions, including those from underserved and minority ethnic groups, more deprived groups and those with lower educational attainments. Further research is also needed on social prescribing or other community-centred approaches. It is unclear what impact the pandemic (and any associated restrictions) could have on the conduct or effectiveness of these interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A rapid review of the effectiveness of innovations to support patients on elective surgical waiting lists

Okolie

Rodriǵuez

Wale

et al. 2022

Preprint

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“…Our findings were also congruent with the most recent meta-analysis conducted by Rodrigues et al (2021), which demonstrated that preoperative chest physiotherapy (breathing interventions) helped to improve postoperative respiratory performance in patients undergoing cardiac surgery. Moreover, the authors concluded that such interventions reduced PPCs and the length of hospital stay [ 37 ]. Other previous studies affirmed the effect of preoperative intervention on PPCs.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

et al. 2022

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Background and Objectives: Patients undergoing cardiac surgery are particularly vulnerable for developing postoperative pulmonary complications (PPCs). This systematic review and meta-analysis aimed to evaluate the role of preoperative chest physiotherapy in such patients. Materials and Methods: All original articles that assessed patients undergoing elective cardiac surgery, with preoperative chest physiotherapy, and compared them to patients undergoing elective cardiac surgery, without preoperative chest physiotherapy, were included. Animal studies, studies conducted prior to the year 2000, commentaries, or general discussion papers whose authors did not present original data were excluded. Studies assessing physiotherapy regimens other than chest physiotherapy were also excluded. The search was performed using the following electronic resources: the Cochrane Central Register of Controlled Trials, the PubMed central database, and Embase. The included studies were assessed for potential bias using the Cochrane Collaboration’s tool for assessing the risk of bias. Each article was read carefully, and any relevant data were extracted. The extracted data were registered, tabulated, and analyzed using Review Manager software. Results: A total of 10 articles investigating 1458 patients were included in the study. The studies were published from 2006 to 2019. The populations were patients scheduled for elective CABG/cardiac surgery, and they were classified into two groups: the interventional (I) group, involving 651 patients, and the control (C) group, involving 807 patients. The meta-analysis demonstrated no significant differences between the interventional and control groups in surgery time and ICU duration, but a significant difference was found in the time of mechanical ventilation and the length of hospital stay, favoring the interventional group. A significant difference was shown in the forced expiratory volume in 1s (FEV1% predicted), forced vital capacity (FVC% predicted), and maximum inspiratory pressure (Pi-max), favoring the interventional group. Conclusions: This study is limited by the fact that one of the included ten studies was not an RCT. Moreover, due to lack of the assessment of certain variables in some studies, the highest number of studies included in a meta-analysis was the hospital stay length (eight studies), and the other variables were analyzed in a fewer number of studies. The data obtained can be considered as initial results until more inclusive RCTs are conducted involving a larger meta-analysis. However, in the present study, the intervention was proved to be protective against the occurrence of PPCs. The current work concluded that preoperative chest physiotherapy can yield better outcomes in patients undergoing elective cardiac surgery.

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“…Our aim was to develop an intervention design through a comprehensive iteractive approach of combined elements of the MRC framework: We have identified a problem in our wards; systematic literature reviews to provide an understanding of what are the pre‐operative education methods used in other health contexts are being conducted (Rodrigues et al., 2021); the underlying theory supporting our intervention is Kitsons’ person‐centred care, which is based on health care that involves the person experiencing a disease process in all decisions, providing them the power of choice, sensitive to the unique needs of each person (Kitson, 2018); the needs of older persons waiting for elective open‐heart surgery according to patients and nurses perceptions were scrutinized in this FG research; an examination of the current practice and context of our cardiothoracic wards is ongoing; and modelling the process and its outcomes is being performed as information gathered is being synthetized. These elements were retrieved from existing models to provide researchers a better opportunity to design an intervention that is effective and will hopefully minimize research waste in health care (Bleijenberg et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

Needs of older persons undergoing cardiac surgery: Exploring the perceptions of nurses, patients waiting for and patients having had surgery

Rodrigues

Henriques

2022

Nursing Open

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Technological and medical advances are increasing which means a growing number of adults are having surgical performances, usually older, higher risk, disabled and debilitated (Abreu, 2018;McCann et al., 2019). Open-heart surgery emerges when conservative ways of treatment are no longer a viable resource, it leads to acute stress, and it is associated with morbidity and mortality related to the underlying disease, surgical technical procedures and other factors (Abreu, 2018;McCann et al., 2019). Relying on evidence found through the years, we should not discuss whether implementing a pre-operative intervention in patients waiting for open-heart surgery is necessary, but rather how to implement it, making it more accessible to all (Ettema et al., 2014;McCann et al., 2019).Open-heart surgery patients are getting older; therefore, caring is increasingly more complex due to comorbid disease, frailty and psychosocial concerns (Abreu, 2018;McCann et al., 2019). It is estimated that in the next few years, the ageing of population will affect the perioperative patient care, and the number of surgical procedures will rise and consequently surgery waiting times (Abreu, 2018).

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Effectiveness of preoperative breathing exercise interventions in patients undergoing cardiac surgery: A systematic review

Cited by 13 publications

References 27 publications

A rapid review of the effectiveness of innovations to support patients on elective surgical waiting lists

A rapid review of the effectiveness of innovations to support patients on elective surgical waiting lists

Effectiveness of Preoperative Chest Physiotherapy in Patients Undergoing Elective Cardiac Surgery, a Systematic Review and Meta-Analysis

Needs of older persons undergoing cardiac surgery: Exploring the perceptions of nurses, patients waiting for and patients having had surgery

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