Chest
Clinical Investigations: Cardiology and Cardiac SurgeryEfficacy of Breathing and Coughing Exercises in the Prevention of Pulmonary Complications After Coronary Artery Surgery
Section snippets
Patients
One hundred twenty-seven consecutive patients undergoing elective CAS who gave informed written consent were included in the study. Patients who were unable to understand written or spoken English were excluded from participation. After obtaining consent, patients were randomly allocated by means of a random numbers table to one of three groups. The study was approved by the Human Ethics Committee of the Royal Adelaide Hospital (RAH).
Group 1: Patients in this group received no chest
RESULTS
Of the initial 120 patients included in the study, seven were early withdrawals following surgery: two from group 1, three from group 2, and two from group 3. Reasons for withdrawal were mechanical ventilation for more than 24 h (four patients) and neurologic complications (three patients). These seven patients were replaced so that an equal number of patients remained in each group.
Descriptive data, including results of pulmonary function testing, for the 120 patients who completed the study
DISCUSSION
Although routine chest physiotherapy is widely used after CAS with the aim of preventing pulmonary complications, relatively few studies could be found which evaluated the efficacy of this treatment.6, 7, 8, 9, 10, 11, 12, 13, 14, 15 In these studies, different regimens of treatment such as breathing and coughing exercises, incentive spirometry, intermittent positive pressure breathing, and periodic application of continuous positive airway pressure were compared. No treatment regimen was found
ACKNOWLEDGMENT
We wish to thank D. Craddock and J. Stubberfield, cardiothoracic surgeons, the interns, registrars, and nursing staff of the Cardiothoracic Surgical Unit and members of the Physiotherapy Department, RAH, for their cooperation. Also, we acknowledge Naomi Haensel, Physiotherapy Department, for her support and encouragement.
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2014, Journal of PhysiotherapyCitation Excerpt :This lack of consensus increases the observed variability in the incidence of postoperative pulmonary complications. In this review, one study did not report on the methods used to diagnose postoperative pulmonary complications,35 four studies used a combination of clinical signs and diagnostic imaging,17,26,27,28 and one study identified the presence of postoperative pulmonary complications using diagnostic imaging alone.18 Only two studies used standardised methods and operational definitions that had been previously described in the literature.27,29
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2011, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :It is important to improve the cough with respiratory physiotherapy and bronchodilators before the surgery. Previous studies have shown that preoperative physiotherapy decreases pulmonary complications after coronary artery bypass grafting, and its continuation prevents pulmonary complications in the postoperative period.18,19 Furthermore, discontinuation of smoking and vigorous pulmonary toilet before surgery are essential in preventing postoperative pulmonary complications in patients with COPD.