Prophylactic respiratory physiotherapy after cardiac surgery: systematic review

摘要: Abstract Objective To assess whether respiratory physiotherapy prevents pulmonary complications after cardiac surgery. Data sources Searches through Medline, Embase, Cinahl, the Cochrane library, and bibliographies, for randomised trials comparing any type of prophylactic with another or no intervention surgery, a follow up at least two days, reporting on outcomes. Review methods Investigators assessed trial validity independently. Information study design, population, interventions, end points was abstracted by one investigator checked others. Results 18 (1457 patients) were identified. Most low quality. They tested physical therapy (13 trials), incentive spirometry (eight), continuous positive airway pressure (five), intermittent breathing (three). The maximum six days. Four only had control; none showed significant benefit physiotherapy. Across all average values postoperatively were: incidence atelectasis, 15-98%; pneumonia, 0-20%; partial arterial oxygen per inspired fraction, 212-329 mm Hg; vital capacity, 37-72% preoperative values; forced expiratory volume in second, 34-72%. No superiority point. For most labour intensive intervention, pressure, cost each patient day €27 (£19; $32). Conclusions usefulness prevention surgery remains unproved. Large are needed controls, clinically relevant points, reasonable periods.