Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery.

Shanlley Cristina Da Silva Fernandes,Raquel Afonso Caserta Eid,Cilene Saghabi De Medeiros Silva,Erica Albanez Giovanetti,Rafaella Souza Dos Santos,Denise Carnieli-Cazati,Karina Tavares Timenetsky,Corinne Taniguchi

doi:10.1590/s1679-45082016ao3398

Shanlley Cristina Da Silva Fernandes, Raquel Afonso Caserta Eid + Show 6 more

Open Access

https://doi.org/10.1590/s1679-45082016ao3398

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Abstract

ABSTRACTObjective To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical.Methods A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group.Results We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength.Conclusion Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery.

Highlights

Static lung volume measurement plays an important role in pulmonary functional assessment, indirectly providing lung elasticity, and establishing forced expiratory flows.[1]
Positive Intermittent Pressure Group was formed by 20 individuals, and the Volumetric Incentive Spirometer Group by 18 individuals
The only significant difference was in the fact that the Positive Intermittent Pressure Group showed a higher number of upper abdominal surgeries (80%), and the Volumetric Incentive Spirometer Group showed a higher number of lower abdominal surgeries (83.3%) (p

Summary

Introduction

Static lung volume measurement plays an important role in pulmonary functional assessment, indirectly providing lung elasticity, and establishing forced expiratory flows.[1] Abdominal surgery, be it upper (above the umbilical line) or lower (below the umbilical line), leads to changes. A review study showed the efficacy of continuous positive airway pressure, aiming to reduce the risk of pulmonary complications in patients undergoing abdominal surgery.[9]. There are few studies that significantly express a comparison between techniques, such as the incentive spirometer and bi-level intermittent positive airway pressure during bedside patient care in the postoperative period of abdominal surgery (upper or lower)

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Conclusion