title: Evaluation of breathing exercise in hormonal and immunological responses in patients undergoing abdominal surgery.
abstract: OBJECTIVE
  To evaluate the effects of sustained deep inspiration in the prevention of postoperative pulmonary complications, the hormonal and immunological responses in patients submitted to abdominal surgery.
  
  
  METHODS
  This randomized clinical trial study included 75 patients submitted to abdominal surgery, of which 36 were randomly allocated in the experimental group and underwent sustained deep inspiration during five seconds, in three sets of ten repetitions per day. The others 39 patients were allocated in the control group and were not submitted to any breathing exercise. The following parameters were measured preoperatively, 24h and 48h postoperatively: chest x-ray, serum ACTH, cortisol, IL-4, IL-10, TNF-α, forced expiratory volume in first second (FEV1), forced expiratory flow 25-75% (FEF 25-75), forced vital capacity (FVC), paO2 and paCO2.
  
  
  RESULTS
  Mean serum cortisol in patients of the experimental and control groups before surgery were 12.8 mcg/dl (4.6-50) and 10.48 mcg/dl (1-29.1), respectively (p=0.414). The experimental group had significantly increase in serum cortisol levels, 23.6 mcg/dl (9.3-45.8), especially 24h postoperatively (p=0.049).
  
  
  CONCLUSIONS
  Sustained deep inspiration in patients submitted to abdominal surgery determined important changes in serum cortisol, however, without significantly influence the postoperative pulmonary complications and the endocrine and immune responses.
authors.affiliation: Department of Surgery, Federal University of Triangulo Mineiro, Uberaba-MG, Brazil.
authors.forename: Elida Mara
authors.initials: EM
authors.lastname: Carneiro
authors.forename: Marisa de Carvalho
authors.initials: Mde C
authors.lastname: Ramos
authors.forename: Guilherme Azevedo
authors.initials: GA
authors.lastname: Terra
authors.forename: Virmondes
authors.initials: V
authors.lastname: Rodrigues Júnior
authors.forename: Délcio
authors.initials: D
authors.lastname: Matos
authors.forename: Eduardo
authors.initials: E
authors.lastname: Crema
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001945:Breathing Exercises; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D001239:Inhalation / Q000502:physiology; D008297:Male; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control*; D013147:Spirometry; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D016207:Cytokines; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone