Prevention of postoperative pulmonary complications through preoperative physiotherapy interventions in patients undergoing coronary artery bypass graft: literature review.
Marina Perelló-Díez, Berta Paz-Lourido
PMID 30154596WHAT IT FOUND
Preoperative physiotherapy before coronary bypass is reported to reduce postoperative lung complications and hospital stay.
Programs combined inspiratory muscle training, education, physical exercise, counselling, breathing exercises, aerobic exercise and complex multidisciplinary care, so no single component can be credited.
Key findings
01Included reviews reported reductions in postoperative lung complications and hospital stay from preoperative programs that included inspiratory muscle training, education, physical exercise, counselling, breathing exercises, aerobic exercise and complex multidisciplinary care.
02One observational follow-up study reported that education in respiratory techniques before surgery reduced atelectasis risk by 52% compared with patients who did not receive it.
03One randomized trial reported that education about ventilatory exercises, general advice and surgery 24 hours before surgery reduced anxiety levels.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 14 articles were selected from 128, and the review did not grade the level of evidence for outcomes from the small clinical trials. The included studies varied widely in design, participants and intervention content, and quality ranged from good to poor in one included review. Many programs combined several treatments, so the benefit of any single component cannot be separated. Some reported improvements were not clinically demonstrable, and the effect of inspiratory muscle training on pneumonia was not conclusive.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that inspiratory muscle training alone prevents postoperative lung complications after coronary bypass. Many studies combined it with education, physical exercise, counselling, breathing exercises, aerobic exercise and complex multidisciplinary care, and the review did not separate those effects.