Lung Expansion Technics on Chest Wall Mechanics and Preventing Pulmonary Complication After Abdominal Surgery
- Conditions
- Surgical Procedure, Unspecified
- Interventions
- Procedure: Breathing exercises
- Registration Number
- NCT01993602
- Lead Sponsor
- University of Sao Paulo General Hospital
- Brief Summary
The lung expansion techniques are widely used to prevent postoperative pulmonary complications. However, the effect of each technique on thoracoabdominal mechanics after abdominal surgery and if it influences the rate of postoperative pulmonary complications remains unknown. The investigators hypothesis is that the lung expansion technique that more increases lung volume after abdominal surgery, will be the most efficient in preventing postoperative pulmonary complication after abdominal surgery. The investigators objectives will be to compare the effect of different lung expansion techniques on lung volumes and activation of inspiratory muscle, and prevention of pulmonary complications in patients undergoing upper abdominal surgery. This study will involve 171 patients undergoing elective abdominal surgery. Patients will be randomly divided into 5 groups: no therapy group (n=35), continuous positive airway pressure (CPAP, n=34); volumetric incentive spirometry (VIS, n=34); flow oriented incentive spirometry (FIS, n=33) and deep breathing (DB, n=35). The thoracoabdominal mechanics will be assessed before and 3 days after surgery. Complications will be evaluated by a researcher who did not know to which group each patient belongs.
- Detailed Description
The assessments performed were thoracoabdominal kinematics (by optoelectronic pletysmography)and respiratory muscles activity (by surface electromyography). The follow pulmonary complications were considered: pneumonia, tracheobronchitis, atelectasis and acute respiratory failed
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 171
- candidates for elective upper abdominal surgery expected to last longer than 120 minutes
- absent of spine or thoracic deformity
- no previous lung parenchyma resection
- no tracheostomy
- able to understand and perform the maneuvers proposed.
- cancellation of surgery
- mechanical ventilation for more than 24 hours in the postoperative period
- need for chest tube use
- postoperative cardiac complications
- surgical complication
- reoperation
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Flow oriented incentive spirometry Breathing exercises patients performed breathing exercises using flow oriented incentive spirometer during five postoperative days Deep breathing group Breathing exercises patients performed deep breathing exercises without any device during five postoperative days volumetric incentive spirometry Breathing exercises patients performed breathing exercises using volumetric incentive spirometer during five postoperative days Continuous positive airway pressure group Breathing exercises patients performed breathing exercises using continuous positive airway pressure group during five postoperative days
- Primary Outcome Measures
Name Time Method thoracoabdominal volume third postoperative day thoracoabdominal volume was evaluated by kinematics (optoelectronic plethysmograph)
- Secondary Outcome Measures
Name Time Method postoperative pulmonary complication participants will be followed for the duration of hospital stay, an expected average of 10 days evaluation of pulmonary complications was performed according to pre-established criteria in the research project
Trial Locations
- Locations (1)
Hospital of Clinics of School of Medicine of University of Sao Paulo
🇧🇷Sao Paulo, Brazil