title: Postoperative Respiratory Exercises Reduce the Risk of Developing Pulmonary Complications in Patients Undergoing Lobectomy.
abstract: OBJECTIVE
  To evaluate the effects of an intensive postoperative physiotherapy program focused on respiratory exercises in patients undergoing lobectomy by open thoracotomy.
  
  
  METHODS
  Quasi-experimental study.
  
  
  METHODS
  Tertiary referral academic hospital.
  
  
  METHODS
  208 patients undergoing lobectomy by open thoracotomy.
  
  
  METHODS
  Control group patients (n=102) received standard medical/nursing care, and experimental group patients (n=106) added to the standard clinical pathway a daily physiotherapy program focused on respiratory exercises until discharge.
  
  
  RESULTS
  Analyzed outcomes were the frequency of postoperative pulmonary complications (PPCs) more amenable to physiotherapy (pneumonia, atelectasis and respiratory insufficiency) and length of hospital stay (LOS).
  
  
  RESULTS
  Both groups were comparable regarding preoperative and surgical characteristics. Incidence of PPCs was 20.6% in control and 6.6% in experimental group (P=.003). Median (IQR) LOS in control group was 14 (7) days (Huber M estimator 14.21) and 12 (6) days (Huber M estimator 12.81) in experimental. Logistic regression model identified the evaluated physiotherapy program (P=.017; EXP [B] 95% CI 0.081-0.780) and % FEV1 (P=.042; EXP [B] 95% CI 0.941-0.999) as protective factors for the development of PPCs in patients undergoing lobectomy.
  
  
  CONCLUSIONS
  Implementing a postoperative intensive physiotherapy program focused on respiratory exercises reduces the risk of PPCs and resultant LOS on patients undergoing lobectomy.
authors: Departamento de Fisiología, Universidad del País Vasco, Leioa, Vizcaya, España.
authors: Ana
authors: A
authors: Rodriguez-Larrad
authors: Servicio de Medicina Física, Complejo Hospitalario de Navarra, Pamplona, España.
authors: Juan Manuel
authors: JM
authors: Vellosillo-Ortega
authors: Servicio de Medicina Física, Complejo Hospitalario de Navarra, Pamplona, España.
authors: Carlos
authors: C
authors: Ruiz-Muneta
authors: Departamento de Medicina Preventiva y Salud Pública, Facultad de Farmacia, Universidad del País Vasco, Vitoria-Gasteiz, España.
authors: Luis Carlos
authors: LC
authors: Abecia-Inchaurregui
authors: Instituto de Biomedicina (IBIOMED), Universidad de León, León, España; Investigador y profesor visitante, Universidad del País Vasco, Leioa, Vizcaya, España. Electronic address: dr.seco.jesus@gmail.com.
authors: Jesús
authors: J
authors: Seco
mesh_terms: D000368:Aged; D001945:Breathing Exercises; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000534:rehabilitation; D011014:Pneumonia / Q000453:epidemiology / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D001261:Pulmonary Atelectasis / Q000453:epidemiology / Q000517:prevention & control*; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000517:prevention & control*; D013147:Spirometry; D062606:Tertiary Care Centers; D013908:Thoracotomy / Q000534:rehabilitation
keywords: Complicaciones postoperatorias; Fisioterapia; Lobectomy; Lobectomía; Physiotherapy; Postoperative complications