Three different mask physiotherapy regimens for prevention of post-operative pulmonary complications after heart and pulmonary surgery.
OBJECTIVE
An investigation into the incidence of post-operative complications after thoracic surgery with 3 different physiotherapy masks.


METHODS
A prospective, consecutive, randomized comparison.


METHODS
Department of Thoracic and Heart Surgery at a University Hospital. The treatments were performed by experienced and specially trained physiotherapists.


METHODS
160 patients were evaluated. 60 patients undergoing heart surgery, 59 patients having pulmonary resection, and 41 patients with exploratory thoracotomy.


METHODS
In each operative category the patients were treated with one of three face mask systems used in addition to routine chest physiotherapy. These were either continuous positive airway pressure (CPAP), positive expiratory pressure (PEP), or inspiratory resistance - positive expiratory pressure (IR-PEP).


RESULTS
Post-operative pulmonary complications were assessed by forced vital capacity (FVC), arterial oxygen tension (PaO2), and chest X-ray examination, all measured pre-operatively and on the fourth and ninth post-operative day. The patients filled in a questionnaire expressing their opinion about their mask treatment. There was an equal decrease in FVC, FVC%, and PaO2, and equal frequency of atelectasis in the 3 mask treatments. More patients with the PEP mask favoured their system than did those with the other 2 systems.


CONCLUSIONS
There was no statistically significant difference between the treatments: continuous positive airway pressure (CPAP), positive expiratory pressure (PEP), and inspiratory resistance - positive expiratory pressure (IR-PEP) on post-operative complications. Any of the three treatments may be used as supplement to standard chest physiotherapy.
Ingwersen
U M
UM
Department of Thoracic and Heart Surgery, Gentofte Hospital, University of Copenhagen, Denmark.
Larsen
K R
KR
Bertelsen
M T
MT
Kiil-Nielsen
K
K
Laub
M
M
Sandermann
J
J
Bach
K
K
Hansen
H
H
D001784:Blood Gas Analysis; D006348:Cardiac Surgical Procedures; D005652:Functional Residual Capacity; D006801:Humans; D015994:Incidence; D008397:Masks; D017060:Patient Satisfaction; D011013:Pneumonectomy; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D011859:Radiography; D011795:Surveys and Questionnaires; D013908:Thoracotomy; D014797:Vital Capacity