Prevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study.
OBJECTIVE
To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit.


METHODS
A randomized clinical trial.


METHODS
A public hospital.


METHODS
Eighty-one patients who had upper abdominal surgery were distributed into two homogeneous groups: control (n = 41) and rehabilitation (n = 40).


METHODS
Breathing exercises in the rehabilitation group.


METHODS
Preoperative and postoperative clinical evaluation, spirometry, arterial gasometry, and simple chest X-rays.


RESULTS
The incidence of PPC was 7.5% in the rehabilitation group and 19.5% in the control group; the control group also had more radiologic alterations (p = .01). Stratified PPC analysis did not reveal significant differences between groups. However, high- and moderate-risk patients in the rehabilitation group had fewer PPC. Multivariate analysis showed a greater PPC risk associated with pulmonary history (p = .02) and duration of surgery longer than 120 min (p = .03), while rehabilitation exerted a protective effect (p = .06). Significant postoperative decreases in pulmonary volumes and arterial gas values were recorded in both groups, without significant differences.


CONCLUSIONS
Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.
Chumillas
S
S
Department of Rehabilitation, Lluis Alcanyís Hospital, Xàtiva, Valencia, Spain.
Ponce
J L
JL
Delgado
F
F
Viciano
V
V
Mateu
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis; D001991:Bronchitis / Q000517:prevention & control* / Q000534:rehabilitation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000517:prevention & control* / Q000534:rehabilitation; D011183:Postoperative Complications / Q000517:prevention & control* / Q000534:rehabilitation; D001261:Pulmonary Atelectasis / Q000517:prevention & control* / Q000534:rehabilitation; D012138:Respiratory Therapy / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014797:Vital Capacity