title: Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery.
abstract: BACKGROUND
  This randomized controlled study evaluated the clinical benefit and physiological effects of prophylactic chest physiotherapy in open major abdominal surgery.
  
  
  METHODS
  A group of 174 patients received chest physiotherapy including breathing with pursed lips, huffing and coughing, and information about the importance of early mobilization. In addition high-risk patients were given resistance training on inspiration and expiration with a mask. The resistance used during inspiration was -5 cmH2O and that during expiration +10 cmH2O. The control group (194 patients) received no information or treatment unless a pulmonary complication occurred.
  
  
  RESULTS
  Oxygen saturation on postoperative days 1-3 was significantly greater in the treatment group. Treated patients were mobilized significantly earlier. No difference was noted in peak expiratory flow rate or forced vital capacity. Postoperative pulmonary complications occurred in 6 per cent of patients in the treatment group and in 27 per cent of controls (P < 0.001). In high-risk patients the numbers with pulmonary complications were six of 40 and 20 of 39 respectively. Pulmonary complications were particularly common in patients with morbid obesity.
  
  
  CONCLUSIONS
  Preoperative chest physiotherapy reduced the incidence of postoperative pulmonary complications and improved mobilization and oxygen saturation after major abdominal surgery.
authors.affiliation: Department of Physiotherapy, University of Göteborg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Fagevik Olsén
authors.forename: I
authors.initials: I
authors.lastname: Hahn
authors.forename: S
authors.initials: S
authors.lastname: Nordgren
authors.forename: H
authors.initials: H
authors.lastname: Lönroth
authors.forename: K
authors.initials: K
authors.lastname: Lundholm
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D007902:Length of Stay; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D026741:Physical Therapy Modalities / Q000379:methods*; D011182:Postoperative Care; D011300:Preoperative Care / Q000379:methods*; D012120:Respiration Disorders / Q000503:physiopathology / Q000517:prevention & control*; D012307:Risk Factors; D013997:Time Factors; D014797:Vital Capacity