Вплив респіраторної фізичної терапії на рівень вільної рідини у плевральних порожнинах після кардіохірургічних втручань

Abstract

The purpose of the study was to investigate the effect of respiratory physical therapy on the level of free fluid in the pleural cavities after cardiac surgery. Materials and methods. The study involved 138 patients. The patients were randomly divided into three groups: control (respiratory physical therapy was limited to cough), group of incentive spirometry (in classes with a physical therapist patients performed additional 3 approaches of 10 breaths through the simulator; they received recommendations for hourly performance of a similar number of cycles of exercise), a group of patients who received additional respiratory physical therapy with positive expiratory pressure in the form of exhalation into a bottle of water through a tube (number of repetitions and recommendations are similar to those received by the previous group). All groups underwent the same protocol of mobilization and use of therapeutic physical exercises in the procedure of therapeutic gymnastics. Performing exercises with breathing simulators began on the 1st postoperative day. Results and discussion. The results of ultrasound examinations of the level of free fluid in the left and right pleural cavities, which were performed according to the postoperative protocol, were studied. The first ultrasound examination, which was analyzed, was performed on the seventh postoperative day, and in the absence of the study on this day, the data of the next study were selected with the registration of the postoperative day number. In addition, the indicators of the final studies of the level of free fluid of the pleural cavities were compared. The position of the patient during the examinations was a sitting one. Analysis of the level of pleural effusion did not establish the benefits of using additional respiratory physical therapy in both groups. The results of studies of the right pleural cavities did not differ in groups of patients, but those of the left ones differed. Conclusion. Pairwise comparison of the groups confirmed the presence of statistically worse results of examinations of the left pleural cavities in the group of incentive spirometry, as well as the absence of statistical differences between the results of the other two groups. The negative effect of incentive spirometry should be confirmed by additional studies, as its effect differed for the results of the left (negative effect) and right (no advantage) pleural cavity