Post-Op Pulmonary Complications

A study concluded that preoperative Inspiratory Muscle Training (IMT) reduced the incidence of Postoperative pulmonary complications and duration of postoperative hospitalization in patients at high risk of developing a pulmonary complication undergoing CABG surgery1.

Another study concluded that Inspiratory Muscle Training (IMT) for 2-4 weeks before coronary artery bypass graft surgery was well tolerated by patients at risk of postoperative pulmonary complications and prevented the occurrence of atelectasis in these patients. A larger randomized clinical trial is warranted2.

Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG Surgery
A Randomized Clinical Trial

2 Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study

Breathing Effort in other Medical Conditions 

Any condition that prevents normal physical activity can lead to inspiratory muscle weakness, and in addition to asthma and Chronic Obstructive Pulmonary Disease (COPD), Inspiratory Muscle Training (IMT), such as with POWERbreathe, has been found to be helpful for managing other medical conditions, including chronic heart failure, postoperative pulmonary complications and inspiratory stridor.

Specific Inspiratory Muscle Training (IMT) of the muscles we use to breathe, such as with POWERbreathe, has been demonstrated to increase their strength, resistance to fatigue and reduce breathlessness, as well as being helpful in managing medical conditions including:

Preoperative IMT for postoperative pulmonary complications

Intervention Review

Preoperative IMT for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery

The objective of this Intervention Review from the Editorial Group: Cochrane Anaesthesia, Critical, and Emergency Care Group, was to assess how effective Inspiratory Muscle Training (IMT) proved to be in adults with postoperative pulmonary complications (PPCs) undergoing cardiac or major abdominal surgery.

CONCLUSIONS:

The authors “found evidence that preoperative IMT was associated with a reduction of postoperative atelectasis, pneumonia, and duration of hospital stay in adults undergoing cardiac and major abdominal surgery. The potential for overestimation of treatment effect due to lack of adequate blinding, small-study effects, and publication bias needs to be considered when interpreting the present findings.”

Pre-operative therapy with IMT prevents some post-operative complications

Preoperative physical therapy for elective cardiac surgery patients (Review)After cardiac surgery, physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications.

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
References 

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.