Effects of Positive Airway Pressure and Incentive With Load Inspiratory on Lung Function and Respiratory Muscle in Post-bariatric Surgery - a Randomized and Blind Clinical Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Inadequate or Impaired Respiratory Function
- Sponsor
- Universidade Metodista de Piracicaba
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Pulmonary function
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Obesity, due to excess fat in the thoracoabdominal region, can promote changes in respiratory function and lung function, leading to reduction in lung volume and capacity. Such dysfunctions are worsen after bariatric surgery to be associated with factors inherent to this procedure. The objective of this study was to evaluate and compare the effects of the application of bilevel positive airway pressure and exercises with inspiratory pressure with linear load in thoracoabdominal mobility, pulmonary function, inspiratory muscle strength, respiratory muscle strength and prevalence of pulmonary complications after bariatric surgery.
Detailed Description
This is a clinical trial, randomized, blinded, in which 60 volunteers, after evaluation preoperatively, consisting of: cirtometry to measure thoracoabdominal mobility, spirometry for measures of lung function, nasal inspiratory pressure to inspiratory muscle strength and endurance incremental test for evaluation of respiratory muscle strength, were randomized and allocated into three groups, with 20 volunteers each. The interventions were performed in the immediate postoperative period and the first day after surgery. The first group, called the control group received care by Conventional Respiratory Physiotherapy (CRP), consisting of breathing exercises, incentive spirometer and ambulation. The second group, called Positive Pressure Group received two-level positive airway pressure for one hour, addition of CRP. The third group, called Load Inspiratory Group held exercises with inspiratory pressure with linear load, linked also to the CRP. Treatments were applied twice in the immediate postoperative period and shortly after returning to the ward and after 4 hours of the initial treatment and three times a day on the first day after surgery. On discharge, the second day after surgery, the volunteers performed chest x-ray and underwent the same evaluations performed preoperatively.
Investigators
Eli Maria Pazzianotto Forti
Principal Investigator
Universidade Metodista de Piracicaba
Eligibility Criteria
Inclusion Criteria
- •Submitted to Roux-en-Y type gastric bypass by laparotomy
- •Normal preoperative pulmonary function and chest x-ray
Exclusion Criteria
- •Hemodynamic instability
- •Hospital Stay longer than three days
- •Presence of postoperative complications
- •Respiratory chronic diseases
Outcomes
Primary Outcomes
Pulmonary function
Time Frame: up to 2 days after surgery
Spirometry was carried out according to the guidelines of the American Thoracic Society (ATS) and European Respiratory Society (ERS) (2005). Three types of maneuver were used in order to evaluate the lumg volumes and flows: slow vital capacity, forced vital capacity and maximum voluntary ventilation. The maneuvers were carried out until three acceptable and reproducible curves were obtained, not exceeding more than eight attemps. The values extracted from each maneuver were selected according to Pereira (2002) and the predicted values calculated using the equation proposed by Pereira et al (1992( for Brazilians.
Secondary Outcomes
- Thoracoabdominal mobility(up to 2 days after surgery)
- Evaluation of inspiratory muscle endurance(up to 2 days after surgery)
- Evaluation of muscle strength inspiratory(up to 2 days after surgery)