Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay

Possa, Samantha Souza; Amador, C. Braga; Costa, A. Meira; Sakamoto, Eliana Takahama; Kondo, Claudia; Vasconcellos, A.L. Maida; Brito, Christina May Moran de; Yamaguti, Wellington Pereira

doi:10.1016/j.rppnen.2014.03.004

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…Early mobilization is standard care for ICU patients and the selection of exercises is based on the patient′s individual abilities ( Schweickert et al, 2009 ; Morris et al, 2016 ; Schaller et al, 2016 ). ICU mobility programs or concepts such as enhanced recovery after surgery and fast track are increasingly implemented and show a reduction in hospital length of stay and the rate of complications ( Ni et al, 2013 ; Souza Possa et al, 2014 ; Fraser et al, 2015 ; Morgan et al, 2016 ; Schujmann et al, 2020 ). In our study, we observed real-time improvement in regional ventilation during mobilization, especially in dorsal sections of the lung.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients

et al. 2021

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Early mobilization has become an important aspect of treatment in intensive care medicine, especially in patients with acute pulmonary dysfunction. As its effects on regional lung physiology have not been fully explored, we conceived a prospective observational study (Registration number: DRKS00023076) investigating regional lung function during a 15-min session of early mobilization physiotherapy with a 30-min follow-up period. The study was conducted on 20 spontaneously breathing adult patients with impaired pulmonary gas exchange receiving routine physical therapy during their intensive care unit stay. Electrical impedance tomography (EIT) was applied to continuously monitor ventilation distribution and changes in lung aeration during mobilization and physical therapy. Baseline data was recorded in the supine position, the subjects were then transferred into the seated and partly standing position for physical therapy. Afterward, patients were transferred back into the initial position and followed up with EIT for 30 min. EIT data were analyzed to assess changes in dorsal fraction of ventilation (%dorsal), end-expiratory lung impedance normalized to tidal variation (ΔEELI), center of ventilation (CoV) and global inhomogeneity index (GI index).Follow-up was completed in 19 patients. During exercise, patients exhibited a significant change in ventilation distribution in favor of dorsal lung regions, which did not persist during follow-up. An identical effect was shown by CoV. ΔEELI increased significantly during follow-up. In conclusion, mobilization led to more dorsal ventilation distribution, but this effect subsided after returning to initial position. End-expiratory lung impedance increased during follow-up indicating a slow increase in end-expiratory lung volume following physical therapy.

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Section: Discussionmentioning

confidence: 99%

The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients

et al. 2021

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“…The results of other studies showed that CPAP mask can be effective in preventing atelectasis after surgery (21)(22)(23). It could be claimed that heart surgery results in reduced lung volumes, alveolar JV&C collapse, and the collapse of some parts of the lungs as atelectasis and diminished oxygenation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Continuous Positive Airway Pressure (CPAP) Masks on Arterial Blood Gas Parameters and Pulmonary Side Effects after Open-heart Surgery

2020

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Background and Aim: Pulmonary side effects are one of the most prevalent and critical sequels following open-heart surgery. A preventive measure for pulmonary side effects after open-heart surgery is to apply continuous positive airway pressure (CPAP) masks. However, studies regarding the usage of these masks have demonstrated contradictory results. Therefore, the present investigation aimed to evaluate the influence of CPAP masks on reducing pulmonary side effects following open-heart surgery. Materials and Methods: This clinical trial was performed on 72 subjects selected through the continuous sampling method out of the patients with open-heart surgery and assigned to two groups of 36 in 2015 in Kashan, Iran. The participants in the test group went under CPAP with 5 cmH2O pressure immediately post-extubation for five times of 30 min with the intervals of 8 h (a total of 150 min during 40 h). On the other hand, the subjects of the control group only received the routine care of the department. Pulmonary sequels, including pleural effusion, pneumothorax, and atelectasis, in addition to some other variables, namely PO2, PCO2, oxygen saturation (O2 Sat), and respiratory rate (RR) were assessed. All the data were analyzed by the Chi-square test and independent t-test. Results: Our findings demonstrated that CPAP application can significantly diminish the occurrence of atelectasis and pleural effusion after open-heart surgery (P<0.05). Moreover, the results revealed that CPAP mask usage leads to a significant reduction in RR and arterial PCO2, while elevates PO2 and O2 Sat significantly (P<0.05). Conclusion:Results of the current study showed that the non-invasive application of CPAP mask immediately post-extubation in patients who undergo open-heart surgery can effectively improve pulmonary function and decrease the incidence of pulmonary side effects, such as atelectasis.

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Correlation between the healthcare guidance and thoracic and upper abdominal post-operative care

Santos

Silva

Nunes

et al. 2020

R.pesq.:cuid.fundam.Online

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Objetivo: Avaliar a influência das orientações em saúde nas complicações no pós-operatório de cirurgias torácicas e abdominais altas. Metodologia: Estudo quantitativo transversal realizada com 266 pacientes. Os dados foram coletados por um questionário sociodemográfico, clínico e assistencial. Foram incluídos pacientes de ambos os sexos, faixa etária de 18 a 80 anos, que estivessem na enfermaria em pós-operatório de cirurgias torácicas e ou abdominais alta. Resultados: Somente 30% dos pacientes receberam orientações no período de pós-operatório e 70% não receberam nenhum tipo de orientação. Quatro dos pacientes que tiveram orientações, desenvolveram algum tipo de complicação e 16 dos que não receberam tiveram complicações; não apresentando resultados estatisticamente significativos quanto aos pacientes que tiveram orientação e os que não tiveram orientações. Conclusão: A maioria dos pacientes, independentemente de ter recebido ou não orientação em saúde não apresentaram uma alta prevalência de complicações no pós-operatório.

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Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay

Cited by 3 publications

References 32 publications

The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients

The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients

Impact of Continuous Positive Airway Pressure (CPAP) Masks on Arterial Blood Gas Parameters and Pulmonary Side Effects after Open-heart Surgery

Correlation between the healthcare guidance and thoracic and upper abdominal post-operative care

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