Effects of oscillatory positive expiratory pressure therapy in patients undergoing thoracic or upper abdominal surgery: A systematic review and meta-analysis

Background: Preventing postoperative complications and accelerating patient recovery are critical issues in clinical treatment and nursing care. This meta-analysis aimed to evaluate the effects of oscillatory positive expiratory pressure therapy (OPEPT) in patients undergoing thoracic or abdominal surgery. Methods: We searched PubMed, the Cochrane Library, Web of Science, EBSCO, SinoMed, Weipu, WanFang, and China National Knowledge Infrastructure (CNKI) for randomized controlled trials (RCTs) on the role of OPEPT on patients undergoing thoracic and upper abdominal surgeries. Two researchers independently conducted literature screening, quality assessment, and data extraction based on the inclusion and exclusion criteria, and used the RevMan 5.4 software to perform the meta-analysis. Results: A total of 13 RCTs involving 1166 patients undergoing thoracic or abdominal surgery were included. The meta-analysis results showed that the decreases in FEV1[MD = 0.30, 95%CI (0.22, 0.38), P < 0.001] and FVC levels [MD = 0.38, 95%CI (0.26, 0.49), P < 0.001] were statistically less in the OPEPT group than those in the control group. OPEPT could increase the postoperative drainage volume [MD = 91.53, 95%CI (57.55, 125.50), P < 0.001] and reduce the length of hospital stay [MD = -1.85, 95%CI (-3.42, -0.28), P = 0.02]. no significant effects on the FEV1/FVC [MD = 2.60, 95%CI (-0.46, 5.67), P = 0.10] and the indwelling time of drainage tube [MD = -1.39, 95%CI (-3.18, 0.41), P = 0.13] between patients undergoing OPEPT and routine care. No publication bias was detected amongst the synthesized outcomes (all P > 0.05). Conclusion: OPEPT, with its promising therapeutic approach, has shown to positively influence the recovery process for patients undergoing thoracic and upper abdominal surgeries. More high-quality, large-sample studies are needed in the future to explore the efficacy and safety of OPEPT.