Osteopathic manipulative treatment in cardiac surgery patients: A systematic review

Objective: Osteopathic manipulative treatment (OMT) in surgical patients aims at reducing postoperative pain and enhancing recovery. The effects of OMT have not been extensively studied in cardiac surgery patients, mostly owing to the fact that a limited number of osteopathic physicians are trained in thoracic surgery. Methods: A systematic review of the literature was performed to identify all currently available data on postoperative OMT in cardiac surgery patients. Case reports and case series were excluded. Risk of bias of the eligible studies was assessed individually using specific protocols. Among the outcomes of interest were postoperative pain, hospital length of stay, changes in respiratory capacity, and changes in cardiac index and mixed oxygen venous saturation (SvO(2)) measurements. Results: We identified four eligible studies which were included in the quantitative analysis of the present review. There were three randomized controlled trials (RCTs) and one non-randomized controlled cohort study which investigated on outcomes of OMT in cardiac surgery patients. The most common cardiac operations performed were coronary artery bypass grafting, valve procedures, combined procedures, and aortic operations. Numerous OMT modalities were used on postoperative patients. The OMT group of patients showed improvement in pain management and respiratory capacity, and shorter hospital length of stay. Conclusions: Osteopathic treatment might be helpful as an adjunct to current medical therapies in mitigating postoperative pain and improving the overall patient's functional status.