A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery.
OBJECTIVE
Physiotherapists use a variety of techniques aimed at improving lung volumes and secretion clearance in patients after surgery. Periodic continuous positive airway pressure (PCPAP) is used to treat patients following elective upper abdominal surgery. However, the optimal method of application has not been identified, more specifically, the dosage of application of PCPAP. The present randomized controlled trial compared the effects of two dosages of PCPAP application and 'traditional' physiotherapy upon functional residual capacity (FRC), vital capacity (VC), oxyhaemoglobin saturation (SpO2), incidence of post-operative pulmonary complications and length of stay with a control group receiving 'traditional' physiotherapy only.


METHODS
Fifty-seven subjects were randomly allocated to one of three groups. All groups received 'traditional' physiotherapy twice daily for a minimum of three post-operative days. In addition, two groups received PCPAP for 15 or 30 minutes, four times per day, for three days.


RESULTS
Fifty subjects (39 male; 11 female) completed the study. There were no significant differences in any variables between the three groups. The overall incidence of post-operative pulmonary complications was 22% in the control group, 11% and 6% in the PCPAP 15-minute and PCPAP 30-minute groups, respectively. Length of hospital stay was not significantly different between the groups but for subjects who developed post-operative pulmonary complications, the length of stay was significantly greater (Z = -2.32; p = 0.021).


CONCLUSIONS
The addition of PCPAP to a traditional physiotherapy post-operative treatment regimen after upper abdominal surgery did not significantly affect physiological or clinical outcomes.
Denehy
L
L
School of Physiotherapy, University of Melbourne, Australia. l.denehy@physio.unimelb.edu.au
Carroll
S
S
Ntoumenopoulos
G
G
Jenkins
S
S
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000704:Analysis of Variance; D001945:Breathing Exercises; D005260:Female; D006801:Humans; D008297:Male; D008397:Masks; D026741:Physical Therapy Modalities / Q000379:methods*; D011175:Positive-Pressure Respiration / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D012120:Respiration Disorders / Q000517:prevention & control*; D015656:Respiratory Mechanics; D018709:Statistics, Nonparametric