Espirometria de incentivo com pressão positiva expiratória é benéfica após revascularização miocardio

Ferreira, Glória Menz; Haeffner, Mauren Porto; Barreto, Sérgio Saldanha Menna; Dall’Ago, Pedro

doi:10.1590/s0066-782x2010000200017

Cited by 19 publications

(11 citation statements)

References 24 publications

(19 reference statements)

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“…Hirschhorn et al. [ 18 ] with physiotherapy and moderate walking and Ferreira et al [ 19 ] with incentive therapy associated with expiratory positive airway pressure. Although the therapy is effective, there is still need for more studies showing the scientific evidence for most physiotherapy techniques [ 20 ] .…”

Section: Discussionmentioning

confidence: 99%

Analysis of a STEPs adapted protocol in Cardiac Rehabilitation in Phase Hospital

Winkelmann

Dallazen

Bronzatti

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveTo analyze a cardiac rehabilitation adapted protocol in physical therapy during the postoperative hospital phase of cardiac surgery in a service of high complexity, in aspects regarded to complications and mortality prevalence and hospitalization days.MethodsThis is an observational cross-sectional, retrospective and analytical study performed by investigating 99 patients who underwent cardiac surgery for coronary artery bypass graft, heart valve replacement or a combination of both. Step program adapted for rehabilitation after cardiac surgery was analyzed under the command of the physiotherapy professional team.ResultsIn average, a patient stays for two days in the Intensive Care Unit and three to four days in the hospital room, totalizing six days of hospitalization. Fatalities occurred in a higher percentage during hospitalization (5.1%) and up to two years period (8.6%) when compared to 30 days after hospital discharge (1.1%). Among the postoperative complications, the hemodynamic (63.4%) and respiratory (42.6%) were the most prevalent. 36-42% of complications occurred between the immediate postoperative period and the second postoperative day. The hospital discharge started from the fifth postoperative day. We can observe that in each following day, the patients are evolving in achieving the Steps, where Step 3 was the most used during the rehabilitation phase I.ConclusionThis evolution program by steps can to guide the physical rehabilitation at the hospital in patients after cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Analysis of a STEPs adapted protocol in Cardiac Rehabilitation in Phase Hospital

Winkelmann

Dallazen

Bronzatti

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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“…A number of studies have reported beneficial effects of pre- and postoperative inspiratory muscle training (IMT) in terms of restored and increased inspiratory muscle strength [ 10 , 11 ], increased forced vital capacity (FVC) [ 14 ], decreased incidence of pneumonia, and decreased time in hospital [ 15 ]. In addition, some studies have shown that breathing exercises in the preoperative and immediate postoperative period increase respiratory muscle strength postoperatively [ 11 , 15 ], whereas others have failed to show any effect [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Urell

Emtner

Hedenström

et al. 2016

J Cardiothorac Surg

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BackgroundPostoperative pulmonary impairments are significant complications after cardiac surgery. Decreased respiratory muscle strength could be one reason for impaired lung function in the postoperative period. The primary aim of this study was to describe respiratory muscle strength before and two months after cardiac surgery. A secondary aim was to describe possible associations between respiratory muscle strength and lung function.MethodsIn this prospective observational study 36 adult cardiac surgery patients (67 ± 10 years) were studied. Respiratory muscle strength and lung function were measured before and two months after surgery.ResultsPre- and postoperative respiratory muscle strength was in accordance with predicted values; MIP was 78 ± 24 cmH2O preoperatively and 73 ± 22 cmH2O at two months follow-up (p = 0.19). MEP was 122 ± 33 cmH2O preoperatively and 115 ± 38 cmH2O at two months follow-up (p = 0.18). Preoperative lung function was in accordance with predicted values, but was significantly decreased postoperatively. At two-months follow-up there was a moderate correlation between MIP and FEV1 (r = 0.43, p = 0.009).ConclusionsRespiratory muscle strength was not impaired, either before or two months after cardiac surgery. The reason for postoperative lung function alteration is not yet known. Interventions aimed at restore an optimal postoperative lung function should focus on other interventions then respiratory muscle strength training.

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“…Já Graetz e Moreno (2015) sugeriu que a terapia com EPAP pode ser capaz de evitar complicações pulmonares como atelectasias e derrames pleurais, considerando que nenhum dos voluntários em seu estudo apresentou complicações radiológicas ou qualquer outra manifestação relacionada às complicações pulmonares decorrentes da CC. Ferreira et al(2010) que utilizou o IR associado a EPAP nos indivíduos do grupo intervenção do pré-operatório e por mais quatro semanas após alta hospitalar pode observar que os pacientes apresentaram menor sensação de dispneia e esforço após o TC6 e menor limitação no aspecto físico e melhor qualidade de vida no grupo que o utilizou IR+EPAP, mas não houve diferença estatísticas significativa entre os grupos nas variáveis espirométricas e na FMR, concordando com Graetz e Moreno (2015) e Bertol et al, (2008). Porém vale salientar que este resultado não é significativo para este estudo para indicar ou não a terapia EPAP na melhora da função pulmonar no PO de CC, pois há grande variação no protocolo terapêutico e tempo de aplicação.…”

Section: Discussionunclassified

Efetividade do dispositivo de pressão positiva na recuperação da função pulmonar no pós-operatório de cirurgia cardíaca: uma revisão integrativa

Ferreira¹,

Teixeira²,

Lima³

et al. 2017

REAS

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Efetividade do dispositivo de pressão positiva na recuperação da função pulmonar no pós-operatório de cirurgia cardíaca: uma revisão integrativaEffectiveness of the positive pressure device in the recovery of pulmonary function in the postoperative period of cardiac surgery: an integrated review Efectividad del dispositivo de presión positiva en la recuperación de la función pulmonar en el postoperatorio de cirugía cardiaca: una revisión integrada Em relação à superioridade entre as técnicas, em dois estudos a respiração com pressão positiva intermitente (RPPI) mostrou ter a possibilidade de melhorar a oxigenação, volumes pulmonares e a força muscular respiratória. A terapia com pressão positiva nas vias aéreas com dois níveis de pressão (Bilevel) refere melhor aceitação dos pacientes a terapia e melhora da oxigenação. Estudos mostram que embora a pressão positiva contínua nas vias aéreas (CPAP) melhore a função pulmonar houve superioridade na terapia com RPPI e Bilevel. Considerações Finais: As modalidades CPAP, Bilevel, RPPI e EPAP podem ser benéficas para melhorar valores gasométricos, função pulmonar e força muscular respiratória, porém não se pode atestar a sua superioridade à FRC. Palavras-chave:Ventilação não invasiva; Procedimentos cirúrgicos cardiovasculares; Cuidados pós-operatórios. ABSTRACTObjectives: Review in the scientific literature the effectiveness of respiratory physiotherapy using positive pressure (PP) and to compare modalities with PP and conventional respiratory physiotherapy (CRP) in the recovery of respiratory function in the postoperative period of cardiac surgery.Methods: Randomized clinical trials of 2006 and 2016 in English and Portuguese were selected from the databases SciELO, BIREME, PubMed, MEDLINE, LILACS, PEDro, and COCHRANE, using descriptors related to the topic. Results: Eleven references were included, where six compared the CRP with some modality of PP. Regarding the superiority between the techniques, in two studies, intermittent positive pressure breathing (IPPB) was shown to have the potential to improve oxygenation, lung volumes and respiratory muscle strength. Positive airway pressure therapy with two levels of pressure (Bilevel) refers to patients' better acceptance of therapy and improvement of oxygenation. Studies show that although continuous positive airway pressure (CPAP) improves pulmonary function there was superiority in the therapy with IPPB and Bilevel. Final Considerations: The

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Espirometria de incentivo com pressão positiva expiratória é benéfica após revascularização miocardio

Cited by 19 publications

References 24 publications

Analysis of a STEPs adapted protocol in Cardiac Rehabilitation in Phase Hospital

Analysis of a STEPs adapted protocol in Cardiac Rehabilitation in Phase Hospital

Respiratory muscle strength is not decreased in patients undergoing cardiac surgery

Efetividade do dispositivo de pressão positiva na recuperação da função pulmonar no pós-operatório de cirurgia cardíaca: uma revisão integrativa

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