Pre- and postoperative inspiratory muscle training in patients undergoing cardiac surgery: systematic review and meta-analysis

被引:51
作者
Gomes Neto, Mansueto [1 ,2 ]
Martinez, Bruno P. [3 ]
Reis, Helena F. C. [1 ]
Carvalho, Vitor O. [4 ]
机构
[1] Univ Fed Bahia, Dept Biofuncao, Salvador, BA, Brazil
[2] Univ Fed Bahia, Programa Posgrad Med & Saude, Salvador, BA, Brazil
[3] Univ Estado Bahia, Dept Fisioterapia, Salvador, BA, Brazil
[4] Univ Fed Sergipe, Dept Fisioterapia, Aracaju, Brazil
关键词
Cardiac surgery; exercise; respiratory muscle training; preoperative care; ARTERY-BYPASS SURGERY; LENGTH-OF-STAY; PULMONARY COMPLICATIONS; INTERNAL MAMMARY; HIGH-RISK; QUALITY; READMISSION; PREDICTORS; MORTALITY; TRIALS;
D O I
10.1177/0269215516648754
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To determine the effects of pre- and postoperative inspiratory muscle training on length of postoperative hospital stay and pulmonary function in patients undergoing cardiac surgery. Design and methods: We conducted a systematic search using databases (MEDLINE, CINAHL, EMBASE, PEDro and the Cochrane) to find controlled trials evaluating the effects of pre- and postoperative inspiratory muscle training. Results: Eight studies fulfilled the inclusion criteria. Four were about preoperative inspiratory muscle training (416 patients), three about postoperative inspiratory muscle training (115 patients) and one study about pre- and postoperative inspiratory muscle training (43 patients). Preoperative inspiratory muscle training resulted in improvement in: Reduction in length of postoperative hospital stay of -2days (95% CI -3.4, -0.7, N=302), inspiratory pressure of 16.7cmH(2)O (95% CI 13.8, 19.5, N=386), forced expiratory volume in one second of 3% predicted (95% CI 0.1, 6, N=140), forced vital capacity of 4.6% predicted (95% CI 1.9, 7.4, N=140). Patients that received preoperative training had an inspiratory muscle training reduced risk of postoperative pulmonary complications, (RR=0.6; 95% CI 0.5 to 0.8; P=0.0004, N=386). Postoperative inspiratory muscle training resulted in improvement in inspiratory pressure of 16.5cmH2O (95% CI 4.9, 27.8, N=115), and tidal volume of 185ml (95% CI 19.7, 349.8, N=85). Conclusion: Pre- and postoperative inspiratory muscle training showed to be a beneficial intervention in the treatment of patients undergoing cardiac surgery.
引用
收藏
页码:454 / 464
页数:11
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