Preoperative inspiratory muscle training prevents pulmonary complications after cardiac surgery - a systematic review

TY - JOUR

T1 - Preoperative inspiratory muscle training prevents pulmonary complications after cardiac surgery - a systematic review

AU - Thybo Karanfil, Emil Osman

AU - Møller, Ann Merete

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2018/3

Y1 - 2018/3

N2 - INTRODUCTION: Post-operative pulmonary complications are a common cause of morbidity and mortality in patients undergoing heart surgery. The aim of this systematic review was to determine if preoperative inspiratory muscle training could prevent the development of pneumonia and atelectasis in patients undergoing coronary artery bypass grafting (CABG) or heart valve surgery.METHODS: Systematic searches were performed in MEDLINE, Embase and the Cochrane Library. The included studies compared the development of pneumonia and atelectasis in CABG patients or heart valve surgery patients who were prescribed either preoperative inspiratory muscle training or usual care. The quality of the studies was assessed using the Cochrane Risk of Bias Tool.RESULTS: The search yielded 2,479 records. The inclusion criteria were fulfilled by five studies. All the studies were randomised controlled trials. We found that the development of both pneumonia and atelectasis was significantly reduced among patients who received inspiratory muscle training preoperatively compared with patients treated with usual care.CONCLUSIONS: Preoperative inspiratory muscle training may reduce the risk of developing pneumonia and atelectasis. However, more trials are needed to support and strengthen the evidence found in this systematic review before routine implementation of this kind of training preoperatively.

AB - INTRODUCTION: Post-operative pulmonary complications are a common cause of morbidity and mortality in patients undergoing heart surgery. The aim of this systematic review was to determine if preoperative inspiratory muscle training could prevent the development of pneumonia and atelectasis in patients undergoing coronary artery bypass grafting (CABG) or heart valve surgery.METHODS: Systematic searches were performed in MEDLINE, Embase and the Cochrane Library. The included studies compared the development of pneumonia and atelectasis in CABG patients or heart valve surgery patients who were prescribed either preoperative inspiratory muscle training or usual care. The quality of the studies was assessed using the Cochrane Risk of Bias Tool.RESULTS: The search yielded 2,479 records. The inclusion criteria were fulfilled by five studies. All the studies were randomised controlled trials. We found that the development of both pneumonia and atelectasis was significantly reduced among patients who received inspiratory muscle training preoperatively compared with patients treated with usual care.CONCLUSIONS: Preoperative inspiratory muscle training may reduce the risk of developing pneumonia and atelectasis. However, more trials are needed to support and strengthen the evidence found in this systematic review before routine implementation of this kind of training preoperatively.

KW - Breathing Exercises

KW - Coronary Artery Bypass/adverse effects

KW - Humans

KW - Length of Stay

KW - Muscle Strength

KW - Pneumonia/prevention & control

KW - Postoperative Complications/prevention & control

KW - Preoperative Care/methods

KW - Pulmonary Atelectasis/prevention & control

KW - Randomized Controlled Trials as Topic

KW - Respiratory Muscles/physiopathology

M3 - Review

C2 - 29510803

SN - 2245-1919

VL - 65

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 3

M1 - A5450

ER -