title: Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study.
abstract: OBJECTIVE
  To determine in a pilot study the feasibility and effects of preoperative inspiratory muscle training in patients at high risk of postoperative pulmonary complications who were scheduled for coronary artery bypass graft surgery.
  
  
  METHODS
  Single-blind, randomized controlled pilot study.
  
  
  METHODS
  University Medical Centre Utrecht, the Netherlands.
  
  
  METHODS
  Twenty-six patients at high risk of postoperative pulmonary complications were selected.
  
  
  METHODS
  The intervention group (N = 14) received 2-4 weeks of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group.
  
  
  METHODS
  Primary outcome variables of feasibility were the occurrence of adverse events, and patient satisfaction and motivation. Secondary outcome variables were postoperative pulmonary complications and length of hospital stay.
  
  
  RESULTS
  The feasibility of inspiratory muscle training was good and no adverse events were observed. Treatment satisfaction and motivation, scored on 10-point scales, were 7.9 (+/- 0.7) and 8.2 (+/- 1.0), respectively. Postoperative atelectasis occurred in significantly fewer patients in the intervention group than in the control group (kappa(2)(DF1) = 3.85; P = 0.05): Length of hospital stay was 7.93 (+/- 1.94) days in the intervention group and 9.92 (+/- 5.78) days in the control group (P = 0.24).
  
  
  CONCLUSIONS
  Inspiratory muscle training for 2-4 weeks before coronary artery bypass graft surgery was well tolerated by patients at risk of postoperative pulmonary complications and prevented the occurrence of atelectasis in these patients. A larger randomized clinical trial is warranted.
authors.affiliation: Section Rehabilitation, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands. h.hulzebos@umcutrecht.nl
authors.forename: Erik H J
authors.initials: EH
authors.lastname: Hulzebos
authors.forename: Nico L U
authors.initials: NL
authors.lastname: van Meeteren
authors.forename: Bram J W M
authors.initials: BJ
authors.lastname: van den Buijs
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
authors.forename: A
authors.initials: A
authors.lastname: Brutel de la Rivière
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
mesh_terms: D000368:Aged; D001945:Breathing Exercises; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D001239:Inhalation; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D001261:Pulmonary Atelectasis / Q000453:epidemiology / Q000517:prevention & control*; D012129:Respiratory Function Tests; D012307:Risk Factors; D016037:Single-Blind Method