Patients undergoing cardiac surgery are at risk of postoperative pulmonary complications such as pneumonia. These complications prolong postoperative recovery and may even lead to death. Increased physical fitness improves people’s functional capacity, including their lungs, and could result in individuals being better prepared to withstand the consequences of the physical stress of surgery.
This latest Intervention Review from the Cochrane Heart Group was to determine if preoperative therapy with an exercise component can prevent postoperative pulmonary complications in cardiac surgery patients, and to evaluate which type of physical therapy is most effective.
The authors of this review evaluated the efficacy and safety of preoperative physical therapy with an exercise component in cardiac surgery patients. From the pertinent literature, eight studies met the inclusion criteria, comprising a total of 856 participants. The results showed that preoperative physical therapy reduced the number of patients who experienced atelectasis or pneumonia but not the number of patients who experienced pneumothorax, prolonged ventilation or postoperative death. Patients who had preoperative physical therapy had an earlier (on average by more than three days) discharge from the hospital. Information on adverse events was limited but those studies that did report on adverse events reported none. None of the studies reported on the costs of preoperative physical therapy.
The authors concluded that preoperative physical therapy, especially inspiratory muscle training, prevents some postoperative complications including atelectasis, pneumonia, and length of hospital stay.
“Preoperative physical therapy for elective cardiac surgery patients (Review)”
Erik HJ Hulzebos, Yolba Smit, Paul PJM Helders, Nico LU van Meeteren
Editorial Group: Cochrane Heart Group, The Cochrane Collaboration 2012
The Cochrane Collaboration is an international network of more than 28,000 dedicated people from over 100 countries, working together to help healthcare providers, policy-makers, patients, their advocates and carers, make well-informed decisions about health care, by preparing, updating, and promoting the accessibility of Cochrane Reviews.