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| ID | Type | Description | Link |
|---|---|---|---|
| FAPESP | Other Grant/Funding Number | 2010/50120-4 |
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| Name | Class |
|---|---|
| Fundação de Amparo à Pesquisa do Estado de São Paulo | OTHER_GOV |
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The lung expansion techniques are widely used to prevent postoperative pulmonary complications. However, the effect of each technique on thoracoabdominal mechanics after abdominal surgery and if it influences the rate of postoperative pulmonary complications remains unknown. The investigators hypothesis is that the lung expansion technique that more increases lung volume after abdominal surgery, will be the most efficient in preventing postoperative pulmonary complication after abdominal surgery. The investigators objectives will be to compare the effect of different lung expansion techniques on lung volumes and activation of inspiratory muscle, and prevention of pulmonary complications in patients undergoing upper abdominal surgery. This study will involve 171 patients undergoing elective abdominal surgery. Patients will be randomly divided into 5 groups: no therapy group (n=35), continuous positive airway pressure (CPAP, n=34); volumetric incentive spirometry (VIS, n=34); flow oriented incentive spirometry (FIS, n=33) and deep breathing (DB, n=35). The thoracoabdominal mechanics will be assessed before and 3 days after surgery. Complications will be evaluated by a researcher who did not know to which group each patient belongs.
The assessments performed were thoracoabdominal kinematics (by optoelectronic pletysmography)and respiratory muscles activity (by surface electromyography). The follow pulmonary complications were considered: pneumonia, tracheobronchitis, atelectasis and acute respiratory failed
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | no intervention was performed in this group during postoperative period, | |
| volumetric incentive spirometry | Active Comparator | patients performed breathing exercises using volumetric incentive spirometer during five postoperative days |
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| Flow oriented incentive spirometry | Active Comparator | patients performed breathing exercises using flow oriented incentive spirometer during five postoperative days |
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| Deep breathing group | Active Comparator | patients performed deep breathing exercises without any device during five postoperative days |
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| Continuous positive airway pressure group | Active Comparator | patients performed breathing exercises using continuous positive airway pressure group during five postoperative days |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breathing exercises | Procedure | The intervention groups (CPAP, VIS, FIS and DB) used the specific device (or not) according to the group allocation. The intervention was performed 3 times per day, from 1 to 5 postoperative day. Patients performed 5 sets of 10 repetitions of the specific breathing exercise, with 30 seconds rest between each set. The sessions were held in the morning, early afternoon and early evening, always supervised by a physiotherapist. Before starting each session, the patient reported the sensation of pain, and if he quantify pain intensity more than 3 in the visual numeric scale (0 to 10) was asked the doctor to administer analgesics aiming that him to perform properly the breathing exercise. |
| Measure | Description | Time Frame |
|---|---|---|
| thoracoabdominal volume | thoracoabdominal volume was evaluated by kinematics (optoelectronic plethysmograph) | third postoperative day |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative pulmonary complication | evaluation of pulmonary complications was performed according to pre-established criteria in the research project | participants will be followed for the duration of hospital stay, an expected average of 10 days |
| Measure | Description | Time Frame |
|---|---|---|
| activity inspiratory muscles | evaluation was performed by surface electromyography | third postoperative day |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Celso R Carvalho, PhD | School of Medicine of University of Sao Paulo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital of Clinics of School of Medicine of University of Sao Paulo | São Paulo | São Paulo | 05403-010 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25973670 | Derived | Lunardi AC, Paisani DM, Silva CCBMD, Cano DP, Tanaka C, Carvalho CRF. Comparison of lung expansion techniques on thoracoabdominal mechanics and incidence of pulmonary complications after upper abdominal surgery: a randomized and controlled trial. Chest. 2015 Oct;148(4):1003-1010. doi: 10.1378/chest.14-2696. |
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| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D001945 | Breathing Exercises |
| ID | Term |
|---|---|
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026241 | Exercise Movement Techniques |
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| D026741 |
| Physical Therapy Modalities |