Preoperative Pulmonary Rehabilitation Research Articles

Factors associated with the complications after lung surgery in the patients with early stage lung cancer: a preliminary study for preoperative pulmonary rehabilitation

Factors associated with the complications after lung surgery in the patients with early stage lung cancer: a preliminary study for preoperative pulmonary rehabilitation

Effect of preoperative pulmonary pehabilitation in patients with lung cancer: a Meta-analysis

Objective To evaluate the efficacy of preoperative pulmonary rehabilitation in patients with lung cancer. Methods We searched Cochrane Library, Web of Science, Pubmed, Embase, CNKI, Wan Fang Date, Vip Date and CBM to collect randomized controlled trials (RCTs) or quasi-experimental study about perioperative pulmonary rehabilitation applied in lung cancer patients, the retrieval time was from 1990 to 2017. The data was analyzed by RevMan 5.3 software after two researchers independently screened the literature, extracted the data, and evaluated the biased risk of inclusion studies. Results A total of 16 studies were included, including 904 patients, and 8 of them were RCT, and 8 quasi-experimental studies. The results of meta-analysis showed that patients after preoperative pulmonary rehabilitation their the first-second forced expiratory volume (FEV1) was increased (MD=0.20, 95%CI: 0.02-0.37, P=0.03) , preoperative forced vital capacity (FVC) was increased (MD=0.22, 95%CI: 0.05-0.38, P=0.009) , preoperative distance of 6-minute walking test (6MWT) was increased (MD=44.07, 95%CI: 33.88-54.27, P<0.001) , the postoperative hospital stay in the preoperative pulmonary rehabilitation group was shortened (MD=-2.28, 95%CI: -2.77-1.79, P<0.001) and the incidence of postoperative pulmonary complications was reduced (OR=0.32, 95%CI: 0.22-0.49, P< 0.001) . Conclusions Preoperative pulmonary rehabilitation can improve lung function of patients with lung cancer, shorten the time of postoperative hospitalization and reduce the incidence of postoperative pulmonary complications. Key words: Meta-analysis; Lung neoplasms; Preoperative pulmonary rehabilitation

Comprehensive Preoperative Pulmonary Rehabilitation Including Intensive Nutritional Support Reduces the Postoperative Morbidity Rate of Sarcopenia-Related Patients with Lung Cancer

Since surgical resection is the treatment of choice for localized lung cancer, it is important to develop an effective strategy to reduce the risk of postoperative complications caused by poor preoperative conditions. We prospectively implemented a comprehensive preoperative pulmonary rehabilitation (CHPPR) program that includes intensive nutritional support with branched-chain amino acids and herbal medicine supplementation concomitant with potential high-intensity physical therapy through an interdisciplinary team approach. This study aimed to evaluate whether CHPPR is beneficial for elderly, low body weight (percentage ideal body weight &lt;90%) patients scheduled to undergo lung surgery. Between 2006 and 2015, 171 patients aged &gt;70 years underwent standard lobectomy for lung cancers. Of these, 12 patients with a low body weight (sarcopenia-related, Group A) and 62 patients without a low body weight (sarcopenia-unrelated, Group B) underwent surgery after CHPPR. Twenty-four patients with a low body weight (sarcopenia-related, Group C) and 73 patients without a low body weight (sarcopenia-unrelated, Group D) refused CHPPR. The postoperative morbidity rates of patients in Groups A, B, C, and D were 17%, 16%, 63%, and 21%, respectively. Of the patients in the sarcopenia-related groups (Groups A and C), those who participated in the CHPPR program (Group A) had a significantly lower morbidity rate than those who did not participate in the CHPPR program (Group C) (P = 0.014). The CHPPR program is beneficial in reducing the postoperative morbidity rate of sarcopenia-related patients scheduled to undergo pulmonary resection.

Preoperative Pulmonary Rehabilitation for Lung Transplant: Effects on Pulmonary Function, Exercise Capacity, and Quality of Life; First Results in Turkey.

The frequency and success rates of lung transplant in patients with end-stage lung disease are increasing. In our study, we investigated the effects of preoperative pulmonary rehabilitation on pulmonary function, exercise capacity, and quality of life in patients who are candidates for lung transplant. This prospective study included 39 consecutive patients who were candidates for lung transplant. All patients underwent preoperative pulmonary rehabilitation for at least 3 weeks. Our patient group included 25 male and 14 female patients with a mean age of 36 years (range, 15 -68 y). Although no significant improvement was shown in the forced expiratory volume in 1 second after pulmonary rehabilitation, significant improvements were observed in the Modified Medical Research Council dyspnea scores (P = .001) and 6-minute walk distance (P = .001). We also observed statistically significant improvements in the Short-Form 36 Quality of Life Questionnaire's physical function (P = .01) and emotional role (P = .02) subparameters. We also found a significant improvement in the Beck Depression Inventory score (P = .004). There was no correlation between Beck Depression Inventory scores before and after rehabilitation and 6-minute walk distance, Short-Form 36, and Modified Medical Research Council dyspnea scores. Our results suggest that preoperative pulmonary rehabilitation improves exercise capacity, reduces the sensation of dyspnea and muscle strength loss, and has a positive effect on the psychologic state of patients who are candidates for lung transplant.

Impact of pulmonary rehabilitation on postoperative complications in patients with lung cancer and chronic obstructive pulmonary disease.

BackgroundGiven the extent of the surgical indications for pulmonary lobectomy in breathless patients, preoperative care and evaluation of pulmonary function are increasingly necessary. The aim of this study was to assess the contribution of preoperative pulmonary rehabilitation (PR) for reducing the incidence of postoperative pulmonary complications in non‐small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD).MethodsThe records of 116 patients with COPD, including 51 patients who received PR, were retrospectively analyzed. Pulmonary function testing, including slow vital capacity (VC) and forced expiratory volume in one second (FEV 1), was obtained preoperatively, after PR, and at one and six months postoperatively. The recovery rate of postoperative pulmonary function was standardized for functional loss associated with the different resected lung volumes. Propensity score analysis generated matched pairs of 31 patients divided into PR and non‐PR groups.ResultsThe PR period was 18.7 ± 12.7 days in COPD patients. Preoperative pulmonary function was significantly improved after PR (VC 5.3%, FEV 1 5.5%; P < 0.05). The FEV 1 recovery rate one month after surgery was significantly better in the PR (101.6%; P < 0.001) than in the non‐PR group (93.9%). In logistic regression analysis, predicted postoperative FEV 1, predicted postoperative %FEV 1, and PR were independent factors related to postoperative pulmonary complications after pulmonary lobectomy (odds ratio 18.9, 16.1, and 13.9, respectively; P < 0.05).Conclusions PR improved the recovery rate of pulmonary function after lobectomy in the early period, and may decrease postoperative pulmonary complications.

Surfactant Protein-D: A sensitive predictor for efficiency of preoperative pulmonary rehabilitation

BackgroundSurfactant Protein D (SP-D) as a lung-derived biomarker for inflammatory lung disease is being studied in depth. Meanwhile, the Pre-operative Rehabilitation Program (PRP) has been proposed as an effective treatment to reduce the incidence of Post-operative Pulmonary Complications (PPCs) and further improve quality of life. However, the relationship between serum SP-D levels and PRP remains unclear. This study aimed to explore the correlation between these two phenomena and validate the feasibility of using preoperative serum SP-D levels to predict or assess the effectiveness of PRP. MethodsA prospective study with a total of 80 lung cancer patients with risk factors for PPCs was conducted; subjects were randomly divided into an Intervention Group (IG, n = 36) and a Control Group (CG, n = 44). The IG was treated with one week of PRP, and the CG was treated for the same duration with routine preoperative preparation before the lobectomy. Peripheral venous blood samples were collected at five time points and serum SP-D levels were measured by enzyme-linked immunosorbent assay (ELISA). We analysed the serum level changes of SP-D as well as the PPCs occurred between the two groups. ResultsBoth groups were comparable at baseline. The average levels of SP-D in both groups showed a decline trend with time, and levels before the day of surgery revealed a significant decline range in the IG compared with the CG (6.56 ± 5.30 vs. 1.05 ± 2.79 ng/ml, P < 0.001). The incidence of PPCs in the IG was significantly lower than in the CG (2/36 vs. 10/44, p = 0.032), as were the PPC person-times occurring from postoperative days 1–4 (POD 1–4) (5/36 vs. 15/44, p = 0.038) and the total person-times (5/36 vs. 19/44, p = 0.004). The overall SP-D levels on the day before surgery in patients with PPCs were significantly higher than those without PPCs (34.07 ± 4.32 vs. 30.30 ± 6.52 ng/ml, p = 0.005); furthermore, the overall SP-D levels on admission day in CG patients with PPCs were also significantly higher than those without PPCs (34.93 ± 4.15 vs. 29.81 ± 7.47 ng/ml, p = 0.045). ConclusionsThe Preoperative Intensity Rehabilitation Program could positively decrease the serum SP-D levels in lung cancer patients with PPC risk factors, and higher preoperative serum SP-D levels may related to a higher incidence of PPCs. Serum SP-D may be a potential predictor for evaluating the efficiency of PRPs and the risk of PPC occurrence.

P1.08-007 The Significant Improvement of Lung Function after Preoperative Rehabilitation in Patients with Thoracic Tumors and Abnormal Spirometry

The evaluation of degree of improvement of exercise tolerance and rest lung function parameters after preoperative pulmonary rehabilitation in patients with thoracic tumors and baseline borderline abnormal spirometry results. Clinical inclusion criteria were: diagnosis of thoracic tumors and reduced values of FEV1 and FVC predicting postoperative complications. We observed 29 patients (16 women, 13 men) in mean age of 68 (range 57-68) years. Spirometry, six minute walking test distance (6MWT) and maximum metabolic equivalent during exercise on treadmill (MET) were chosen for evaluation of lung function and physical performance during rehabilitation. The tests were performed twice during screening phase to eliminate the factors of learning, and were repeated after first and second week of rehabilitation. Pulmonary rehabilitation included two weeks of training on the treadmill with individually selected speed, physiotherapy exercises and breathing training with using of Triflo. The significant differences were observed after pulmonary rehabilitation: 1). FEV 1 (L): 1.41 vs 1.58 (p=0.000027) 2). FEV1 (%N): 60.49 vs 71.49 (p=0.000021) 3). FVC (L): 2.34 vs 2.64 (p=0. 000520) 4). FVC (%N): 79 vs 95 (p=0.000269) 5). 6MWT Distance (m): 350 vs 400 (p=0.000007) 6). MET: 2.66 vs 2.905 (p=0.000007). A two-week pulmonary rehabilitation leads to significantly improvement of lung function and physical performance in patients with thoracic tumors and borderline abnormal spirometry results which may provide significantly better outcome of patients in short- and longtime follow-up.

Preoperative exercise training prevents functional decline after lung resection surgery: a randomized, single-blind controlled trial

Objectives: To investigate the effects of a preoperative pulmonary rehabilitation programme in patients with lung cancer undergoing video-assisted thoracic surgery. Design: Randomized, single-blind controlled trial. Setting: Teaching hospital. Subjects: Patients with suspected or confirmed lung cancer undergoing video-assisted thoracic surgery. Intervention: Participants were randomized to either a prehabilitation group or a control group. Participants in the prehabilitation group underwent a combination of moderate endurance and resistance training plus breathing exercises three to five times per week. Main measures: The primary outcome of the study was exercise capacity. Secondary outcomes were muscle strength (Senior Fitness Test), health-related quality of life (Short-Form 36) and the postoperative outcomes. Patients were evaluated at baseline (before randomization), presurgery (only the prehabilitation group), after surgery and three months post-operatively. Results: A total of 40 patients were randomized and 22 finished the study (10 in the prehabilitation group and 12 in the control group). Three patients were lost to follow-up at three months. After the training, there was a statistically significant improvement in exercise tolerance (+397 seconds, p = 0.0001), the physical summary component of the SF-36 (+4.4 points, p = 0.008) and muscle strength (p < 0.01). There were no significant differences between groups after surgery. However, three months postoperatively, significant differences were found in the mean change of exercise capacity (p = 0.005), physical summary component (p = 0.001) and upper and lower body strength (p = 0.045 and p = 0.002). Conclusions: A pulmonary rehabilitation programme before video-assisted thoracic surgery seems to improve patients’ preoperative condition and may prevent functional decline after surgery. Clinical Registration Number: NCT01963923 (Registration date 10/10/2013)

Preoperative pulmonary rehabilitation for marginal-function lung cancer patients.

Background This study aimed to evaluate the impact of preoperative pulmonary rehabilitation in lung cancer patients undergoing pulmonary resection surgery with marginal lung function. Methods Short-term outcomes of 42 patients with forced expiratory volume in 1 s < 1.6 L who underwent lung resection between 01/2006 and 12/2010 were reviewed retrospectively. They were divided into group A (no preoperative pulmonary rehabilitation) and group B (receiving pulmonary rehabilitation). In group B, a second set of pulmonary function tests was obtained. Results There were no significant differences in terms of sex, age, race, pathologic stage, operative procedure, or smoking years. Mean forced expiratory volume in 1 s and diffusing capacity for carbon monoxide in group A was 1.40 ± 0.22 L and 10.28 ± 2.64 g∙dL-1 vs. 1.39 ± 0.13 L and 10.75 ± 2.08 g∙dL-1 in group B. Group B showed significant improvement in forced expiratory volume in 1 s from 1.39 ± 0.13 to 1.55 ± 0.06 L ( p = 0.02). Mean intensive care unit stay was 6 ± 5 days in group A vs. 9 ± 9 days in group B ( p = 0.22). Mean hospital stay was 10 ± 4 days in group A vs. 14 ± 9 days in group B ( p = 0.31). There was no significant difference in morbidity or mortality between groups. Conclusion Preoperative pulmonary rehabilitation can significantly improve forced expiratory volume in 1 s in some marginal patients undergoing lung cancer resection. However, it does not improve length of stay, morbidity, or mortality.

Impact and Effect of Preoperative Short-term Pulmonary Rehabilitation Training on Lung Cancer Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease: A Randomized Trial

背景与目的围术期肺康复训练计划能够加速肺癌手术患者的术后快速康复，但是其应用方案、时间等仍未统一。肺癌合并慢性阻塞性肺病（chronic obstructive pulmonary disease, COPD）的手术患者，由于其相对较差的肺功能及心肺耐力，一直以来，都是肺部相关并发症的高危人群。本研究旨在探讨术前短期综合肺康复训练对肺癌合并轻中度COPD手术患者的影响。方法前瞻性分析2015年3月11日至2015年11月31日四川大学华西医院胸外科行肺叶切除的原发性非小细胞癌合并轻中度COPD患者48例，随机分成实验组和对照组；实验组患者术前完成一周短期综合肺康复方案，包括以雾化吸入普米克令舒、博利康尼和沐舒坦静脉滴注为主的药物康复以及呼吸训练+耐力训练（Nustep）的物理康复；而对照组患者按常规术前准备进行。结果最终24例患者纳入实验组，24例患者纳入对照组：实验组患者的术后住院时间[(6.17±2.91) d vs (8.08±2.21) d; P=0.013]和术后抗生素使用时间[(3.61±2.53) d vs (5.36±3.12) d; P=0.032]低于对照组，总住院费用[(46, 455.6±5, 080.9) ￥ vs (45, 536.0±4, 195.8) ￥, P=0.498]、住院材料费用[(21, 155.5±10, 512.1) ￥ vs (21, 488.8±3, 470.6) ￥, P=0.883]、住院药物费用[(7, 760.3±2, 366.0) ￥ vs (6, 993.0±2, 022.5) ￥, P=0.223]在两组间均无统计学差异；实验组患者对比训练前后，最大峰值流速（peak expiratory flow, PEF）[(268.40±123.94) L/min vs (343.71±123.92) L/min; P < 0.001]、6分钟运动距离（6-min walk distance, 6-MWD）[(595.42±106.74) m vs (620.90±99.27) m; P=0.004]及能量消耗[(59.93±10.61) kcal vs (61.03±10.47) kcal; P=0.004]提高；术后肺部相关并发症（postoperative pulmonary complications, PPCs）发生率（8.3%, 2/24 vs 20.8%, 5/24, P=0.416）差异无统计学意义。结论术前短期综合肺康复训练能够提高肺癌合并轻中度慢性阻塞性肺病患者心肺耐力，加速患者术后快速康复，可作为术前快速康复计划的重要部分。

Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial

BackgroundAs a newly developed treatment, preoperative pulmonary rehabilitation (PR) has been studied in depth. However, few studies have assessed the relationship between advanced age and a shorter term intensive pattern of preoperative PR in patients with lung cancer (LC) and especially those patients waiting for therapeutic LC surgeries. This study investigated short-term preoperative PR combined with inspiratory muscle training (IMT) and aerobic endurance training in elderly patients scheduled to undergo LC lobectomy. MethodsA prospective randomized controlled trial with a total of 60 subjects aged ≥70 y was conducted. The intervention group (PR group) was treated for 1 wk with systematic and highly intensive preoperative PR training before lobectomy, and the control group (NPR group) was treated with conventional preoperative respiratory management. We analyzed the 6-min walking distance (6-MWD), the peak expiratory flow (PEF), and quality-of-life scores before and after the rehabilitation regimen as well as the incidence of postoperative pulmonary complications (PPCs). ResultsIn total, 30 patients (PR group) completely executed the 7-d intensive preoperative PR, and 30 patients (NPR group) served as the control group. The two groups were comparable at baseline. During the preoperative PR, a significantly longer 6-MWD (increase: 28.6 ± 18.2 versus 9.4 ± 27.0 m; between-groups difference: 19.2 m, P = 0.029) and an increased PEF (increase: 26.2 ± 22.5 versus 8.2 ± 10.3 L/min; between-groups difference: 18.0 L/min, P < 0.001) were noted in the PR group compared with the NPR group. After LC surgery, the mean postoperative length of stay (6.9 ± 4.4 versus 10.7 ± 6.4 d, P = 0.010) and total hospital stay (16.0 ± 4.5 versus 19.7 ± 6.5 d, P = 0.012) were significantly reduced in the PR group. Thirty-day PPCs were noted in four (13.3%) patients in the PR group and 11 (36.7%) patients in the NPR group, with a significant difference between the two groups (P = 0.037). ConclusionsFor elderly LC patients scheduled to undergo surgery in China, a 7-d intensive pattern of preoperative PR combined with IMT and aerobic endurance training may be a feasible rehabilitation strategy with positive physical and psychological effects.

“What’s the Risk?” Assessing and Mitigating Risk in Cardiothoracic Surgery

“What’s the Risk?” Assessing and Mitigating Risk in Cardiothoracic Surgery

Impact of preoperative pulmonary rehabilitation on the Thoracoscore of patients undergoing lung resection.

Patients with dyspnoea who are suitable for lung resection have a higher in-hospital mortality following surgery as predicted by the Thoracoscore. We evaluated the role of preoperative pulmonary rehabilitation (PPR) in improving preoperative dyspnoea, performance status and thereby the Thoracoscore and reducing the risk of postoperative mortality, complications and length of stay in such patients. From June 2013 until May 2014, we prospectively and sequentially identified high-risk patients in our outpatient clinic with dyspnoea grade ≥2 and performance status ≥1 for lung resection and recruited them for PPR. Thoracoscores, dyspnoea grade and performance status before and after PPR were calculated for all patients. Hospital mortality, complication rates and the length of hospital stay following surgery were compared between those who received PPR with those who did not undergo PPR and instead went straight to surgery. Of the 42 patients (67% females, mean age 67 years [SD 13]) identified, 33 patients received PPR for a mean duration of 7.1 [SD 6.5] days. Their mean Thoracoscores before and after PPR were 6.4 [SD 5.1] and 1.7% [SD 1.3] (P < 0.00009); dyspnoea grade 3.8 [SD 0.6] and 2.2 [SD 0.6] (P < 0.00001); and performance status 2.7 [SD 0.5] and 1.7 [SD 0.6] (P < 0.00001), respectively. The postoperative mortality in those who received PPR and those who did not undergo PPR but went straight to surgery, respectively, was 0 vs 11.1% (P = 0.05), postoperative complication rate was 5.3 vs 37.5% (P < 0.015) and the mean length of hospital stay was 8.7 [SD 3.5] days vs 10.3 [SD 6.2] days (P = 0.26), respectively. Our prospective study suggests that in those patients with dyspnoea requiring lung resection, PPR significantly improves their exercise capacity, reduces dyspnoea and improves the Thoracoscore. The study also suggests that PPR helps reduce postoperative complications and obviates the increased length of hospital stay and in-hospital mortality that may be otherwise expected.

Impact of a Pre-Operative Pulmonary Rehabilitation Program on Functional Performance In Patients Undergoing Video-assisted Thoracic Surgery for Lung Cancer

Impact of a Pre-Operative Pulmonary Rehabilitation Program on Functional Performance In Patients Undergoing Video-assisted Thoracic Surgery for Lung Cancer

Preoperative high-intensity training in frail old patients undergoing pulmonary resection for NSCLC.

Thoracic surgery remains the better therapeutic option for non-small cell lung cancer patients that are diagnosed in early stage disease. Preoperative lung function assessment includes respiratory function tests (RFT) and cardio-pulmonary exercise testing (CPET). Vo2 peak, FEV1 and DLCO as well as recognition of performance status, presence of co-morbidities, frailty indexes, and age predict the potential impact of surgical resection on patient health status and survival risk. In this study we have retrospectively assessed the benefit of a high-intensity preoperative pulmonary rehabilitation program (PRP) in 14 patients with underlying lung function impairment prior to surgery. Amongst these, three patients candidate to surgical resection exhibited severe functional impairment associated with high score of frailty according CHS and SOF index, resulting in a substantial mortality risk.Our observations indicate that PRP appear to reduce the mortality and morbidity risk in frail patients with concurrent lung function impairment undergoing thoracic surgery. PRP produced improvement of VO2 peak degree and pulmonary function resulting in reduced postoperative complications in high-risk patients from our cases. Our results indicate that a preoperative training program may improve postoperative clinical outcomes in fraillung cancer patients with impaired lung function prior to surgical resection.

Clinical benefit of comprehensive preoperative pulmonary rehabilitation through an interdisciplinary team approach for the elderly, low body weight, lung cancer patients

Clinical benefit of comprehensive preoperative pulmonary rehabilitation through an interdisciplinary team approach for the elderly, low body weight, lung cancer patients

Efficacy of Comprehensive Preoperative Pulmonary Rehabilitation Including Intensive Nutritional Support through an Interdisciplinary Team Approach

Efficacy of Comprehensive Preoperative Pulmonary Rehabilitation Including Intensive Nutritional Support through an Interdisciplinary Team Approach

Nurse led Patient Education Programme for patients undergoing a lung resection for primary lung cancer.

There has been an increase in the number of patients undergoing lung resection for primary or suspected primary lung cancer in the UK due to improved staging techniques, dedicated thoracic surgeons and other initiatives such as preoperative pulmonary rehabilitation. This has had an impact on local healthcare resources requiring new ways of delivering thoracic surgical services. When considering service changes, patient reported outcomes are pivotal in terms of ensuring that the experience of care is enhanced and may include elements such as involving patients in their care, reducing the length of inpatient stay and reducing postoperative complications. The implementation of a thoracic surgical Patient Education Programme (PEP) has the potential to address these measures and improve the psychological and physical wellbeing of patients who require a lung resection. It may also assist in their care as an inpatient and to enhance recovery after surgery both in the short and long term.

Complications after video-assisted thoracic surgery in patients with pulmonary nontuberculous mycobacterial lung disease who underwent preoperative pulmonary rehabilitation

[Purpose] Video-assisted thoracic surgery and preoperative pulmonary rehabilitation are effective in preventing postoperative complications in patients with cardiopulmonary disease. The present study aims to elucidate the presence of postoperative pneumonia and atelectasis in patients with nontuberculous mycobacterial lung disease who underwent lung resection with video-assisted thoracic surgery and preoperative pulmonary rehabilitation. [Subjects and Methods] Nineteen patients with nontuberculous mycobacterial lung disease who had undergone lung resection with video-assisted thoracic surgery and preoperative pulmonary rehabilitation were enrolled in this study. The presence of postoperative pneumonia and atelectasis was evaluated, and preoperative and postoperative pulmonary functions were compared. [Results] Postoperative pneumonia and postoperative atelectasis were not observed. Decreases of pulmonary function were 5.9% (standard deviation, 8.5) in forced vital capacity (percent predicted) and 9.6% (standard deviation, 11.1) in forced expiratory volume in 1 s (percent predicted). [Conclusion] The present study indicates that the combination of lung resection with video-assisted thoracic surgery and preoperative pulmonary rehabilitation in patients with nontuberculous mycobacterial lung disease may be effective in preventing postoperative complications.

Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: a randomized clinical trial.

Introduction: Prevention of pulmonary complications after coronary artery bypass graft is attended as a very important issue. The aim of this study was to evaluate the role of pulmonary rehabilitation before surgery for reducing the risk of pulmonary complications after surgery. Methods: In a randomized clinical trial, 60 patients undergoing heart surgery were randomly divided into two groups A and B. Chest physiotherapy was performed before and after surgery on group A patients however it was done on group B’s, only after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and arterial blood gas (ABG). Results: Thirty nine males (65%) and 21 females (35%) with mean age of 8.10 ± 9.56 were analyzed. The mean differences were statistically significant for predicted forced vital capacity (FVC) (CI 95%:1.3 to 8.7) and Predicted Peak Flow indices (PEF) (CI 95%: 1.9 to 9.4) of spirometry indicator, PCO2 index (of ABG parameter) (CI 95%: 1.4 to 8.9) and mean oxygen saturation (mean Spo2) (CI 95%: 0.6 to 1.7) of ABG index in two groups. Conclusion: The performance of pulmonary rehabilitation program before surgery is recommended, as it may result in the reduction of complications of heart surgery