Feasibility and Effectiveness of Pre‐operative Inspiratory Muscle Training in Patients Undergoing Oesophagectomy: A Pilot Study

Dettling, Daniela S; Schaaf, Marike van der; Blom, Rachel L. G. M.; Nollet, Frans; Busch, Olivier R.; Henegouwen, Mark I. van Berge

doi:10.1002/pri.1524

Cited by 86 publications

(88 citation statements)

References 26 publications

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“…This is in line with earlier studies that show that IMT can improve inspiratory muscle strength and endurance after 2 weeks of training in patients undergoing major invasive surgery [16,38,39]. Baseline values and the average increase of 20% of MIP-max are also comparable to the results in these studies.…”

Section: Discussionsupporting

confidence: 82%

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Valkenet¹,

Trappenburg²,

Schippers

et al. 2016

Dig Surg

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Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not scheduled within 2 weeks. Results: The 115 participants followed on average 5.7 (3.5) training sessions. Adherence to the exercise program was high: 82% of the planned training sessions were attended, and no adverse events occurred. Mixed model analyses showed a significant increase of maximal inspiratory muscle strength (84.1-104.7 cm H₂O; p = 0.00) and inspiratory muscle endurance (35.0-39.5 cm H₂O; p = 0.00). No significant changes were found in aerobic capacity and peripheral muscle strength. Conclusion: This exercise program in patients awaiting oncological surgery is feasible in terms of participation and adherence. Inspiratory muscle function improved significantly as a result of inspiratory muscle training. The exercise program however failed to result in improved aerobic capacity and peripheral muscle strength, probably due to the limited number of training sessions as a result of the restricted time interval between screening and surgery.

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Section: Discussionsupporting

confidence: 82%

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Valkenet¹,

Trappenburg²,

Schippers

et al. 2016

Dig Surg

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show abstract

“…60,61 Preoperative inspiratory muscle training has been shown in one study to improve respiratory function, but not outcome, in patients undergoing esophagectomy. 62 However, this study may have been underpowered, as reductions in pulmonary complications were demonstrated by a large randomized controlled trial in high-risk cardiac patients. 63 It is biologically plausible that the non-lipid-decreasing effects of HMG-CoA (3-hydroxy-3-methyl-glutaryl coenzyme A) reductase inhibitors (statins) may modify many of the underlying processes that lead to the development of acute respiratory distress syndrome (ARDS) in surgical patients.…”

Section: Preoptimizationmentioning

confidence: 98%

Anesthesia for Esophagectomy

Carney

Dickinson

2015

Anesthesiology Clinics

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“…Dettling et al 17 reported that preoperative IMT is feasible in patients with esophageal carcinoma, resulting in significant improvement in respiratory muscle function. In that study, resistance improved significantly after IMT in 32% and 41% of the patients, respectively (p <0.001).…”

Section: ■ Discussionmentioning

confidence: 99%

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

et al. 2018

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Purpose: To compare pulmonary and nutritional parameters before and after inspiratory muscle training (IMT) and enteral feeding support in patients with esophageal disease undergoing preoperative outpatient follow-up. Methods: Thirty patients with a mean age of 55.83 years, 16 men and 14 women, were included. Pulmonary assessment consisted of the measurement of MIP, MEP, and spirometry. Anthropometric measurements and laboratory tests were performed for nutritional assessment. After preoperative evaluation, inspiratory muscle training and enteral nutrition support were started. A p<0.05 was considered statistically significant. Results: After an outpatient follow-up period of 4 weeks, a significant increase in MIP (-62.20 ± 25.78 to -81.53 ± 23.09), MEP (73.4 ± 31.95 to 90.33 ± 28.39), and FVC (94.86 ± 16.77 to 98.56 ± 17.44) was observed. Regarding the anthropometric variables, a significant increase was also observed in BMI (20.18 ± 5.04 to 20.40 ± 4.69), arm circumference (23.38 ± 3.28 to 25.08 ± 4.55), arm muscle circumference (21.48 ± 3.00 to 22.07 ± 3.36), and triceps skinfold thickness (5.62 ± 2.68 to 8.33 ± 6.59). Conclusion: Pulmonary and nutritional preparation can improve respiratory muscle strength, FVC and anthropometric parameters. However, further studies are needed to confirm the effectiveness of this preoperative preparation.

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Feasibility and Effectiveness of Pre‐operative Inspiratory Muscle Training in Patients Undergoing Oesophagectomy: A Pilot Study

Abstract: Pre-operative IMT is feasible in patients with oesophageal carcinoma and significantly improves respiratory muscle function. This, however, did not result in a reduction of post-operative pneumonia in patients undergoing oesophagectomy.

Cited by 86 publications

References 26 publications

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Anesthesia for Esophagectomy

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

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