Volumetric incentive spirometer and positive pressure after cardiac surgery

  • Aline C. M Azambuja Universidade Luterana do Brasil
  • Milene A Souza Hospital Universitário ULBRA/Mãe de Deus - Canoas/RS
  • Eduarda P Ranzoni Universidade Luterana do Brasil
  • Juliana S Wioppiold Universidade Luterana do Brasil
  • Lizia Marcela P Muzykant Universidade Luterana do Brasil
  • Pricila O Costa Universidade Luterana do Brasil
  • Cristiane B.E Trevisan
  • Laura J Santos Universidade Luterana do Brasil
Keywords: cardiac surgery, post-operative complications, non-invasive ventilation, positive pressure breathing, incentive spirometer

Abstract

Background:Most patients that undergo cardiac surgery develop post-operative pulmonary complications. The use of an incentive spirometer associated withpositive end-expiratory pressure (PEEP) and non-invasive ventilation (NIV) may contribute to the reduction of such complications.

Objective: To compare the efficacy of an incentive spirometer associated with positive end-expiratory pressure to NIV in pulmonary complications in the PO of heart surgery during hospitalization in the intensive care unit (ICU).

Methods: A randomized clinical trial conducted from July 2012 to July 2015 at the ULBRA Mãe de Deus University Hospital -Canoas/RS. Patients were randomized into three groups: Group I – NIV; group II - volumetricincentive spirometer (IS) associated with positive end-expiratory pressure (PEEP) (IS+EPAP); and group III - conventional (CG). The three groups received motor physiotherapy. Post-operative monitoring of pulmonary complications was performed through radiology service reports until the time of discharge from the ICU.

Results: 49 patients were included in the study, 13 patients in Group I, 16 patients in Group II and 20 patients in Group III. The average age of Group I was 61.7 ± 10.4 years, 61.4 ± 10.2 years in Group II, and 62.9 ± 11.5 years in Group III. Atelectasis was the pulmonary complication that had the highest statistical significance when comparing the three groups in the immediate PO (p=0.035).

Conclusion: When comparing non-invasive ventilation (NIV) to incentive spirometry (IS) associated with positive end-expiratory pressure (PEEP) or respiratory exercises, we could not conclude that this particular technique is superior in relation to the decrease of pulmonary complications.

 

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Author Biographies

Aline C. M Azambuja, Universidade Luterana do Brasil
Fisioterapeuta - Residência Multiprofissional em saúde do adulto e idoso ULBRA/Mãe de Deus - Canoas/RS
Milene A Souza, Hospital Universitário ULBRA/Mãe de Deus - Canoas/RS
Fisioterapeuta - Hospital Universitário ULBRA/Mãe de Deus - Canoas/RS
Eduarda P Ranzoni, Universidade Luterana do Brasil
Fisioterapeuta -  Universidade Luterana do Brasil – ULBRA – Canoas/RS
Juliana S Wioppiold, Universidade Luterana do Brasil
Fisioterapeuta -  Universidade Luterana do Brasil – ULBRA – Canoas/RS
Lizia Marcela P Muzykant, Universidade Luterana do Brasil
Fisioterapeuta -  Universidade Luterana do Brasil – ULBRA – Canoas/RS
Pricila O Costa, Universidade Luterana do Brasil
Fisioterapeuta -  Universidade Luterana do Brasil – ULBRA – Canoas/RS
Cristiane B.E Trevisan
Fisioterapeuta
Laura J Santos, Universidade Luterana do Brasil
Doutora, Fisioterapeuta, docente do Curso de Fisioterapia da Universidade Luterana do Brasil – ULBRA – Canoas/RS.
Published
19-09-2016
How to Cite
AZAMBUJA, A. C. M.; SOUZA, M. A.; RANZONI, E. P.; WIOPPIOLD, J. S.; MUZYKANT, L. M. P.; COSTA, P. O.; TREVISAN, C. B.; SANTOS, L. J. Volumetric incentive spirometer and positive pressure after cardiac surgery. Journal of Respiratory and CardioVascular Physical Therapy, v. 4, n. 1, p. 21-28, 19 Sep. 2016.
Section
Artigos