Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial
ABSTRACT BACKGROUND: Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS). OBJECTIVE: To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary c...
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| Format: | Article |
| Jezik: | English |
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Associação Paulista de Medicina
2021-11-01
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| Serija: | São Paulo Medical Journal |
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| Online dostop: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000600556&tlng=en |
| _version_ | 1831706925470842880 |
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| author | Mona Mohamed Taha Ramy Salama Draz Mohamed Mostafa Gamal Zizi Mohamed Ibrahim |
| author_facet | Mona Mohamed Taha Ramy Salama Draz Mohamed Mostafa Gamal Zizi Mohamed Ibrahim |
| author_sort | Mona Mohamed Taha |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS). OBJECTIVE: To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary complications (PPCs). DESIGN AND SETTING: Randomized controlled study conducted at Kasr Al-Ainy teaching hospital, Egypt. METHODS: A randomized controlled trial was conducted on 48 subjects undergoing elective UAS with high risk of developing PPCs. The study group received AD plus routine chest physiotherapy (deep diaphragmatic breathing, localized breathing and splinted coughing) and the control group received routine chest physiotherapy only. The outcomes included arterial blood gases measured at the first and seventh postoperative days, incidence of PPCs within the first seven days and length of hospital stay. RESULTS: Baseline characteristics were similar between groups. In the AD group, SaO2, PaO2, PaCO2 and HCO3 significantly improved (P < 0.05) while in the physiotherapy group, only SaO2 and PaO2 significantly improved (P < 0.05). Nonetheless, significant differences in post-treatment SaO2 and PaO2 between the groups were observed. The overall incidence of PPCs was 16.66% (12.5% in the AD group and 20.8% in the physiotherapy group) (absolute risk reduction -8.3%; 95% confidence interval, CI, -13.5 to 29.6%), with no significant difference between the groups. The AD group had a significantly shorter hospital stay (P = 0.0001). CONCLUSION: Adding AD to routine chest physiotherapy after UAS provided a favorable blood gas outcome and reduced the length of hospital stay. It tended to reduce the incidence of PPCs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04446520. |
| first_indexed | 2024-12-20T16:48:51Z |
| format | Article |
| id | doaj.art-a0b50c33e6ac4ee9baf7645d23f73ffd |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-20T16:48:51Z |
| publishDate | 2021-11-01 |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-a0b50c33e6ac4ee9baf7645d23f73ffd2022-12-21T19:32:52ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602021-11-01139655656310.1590/1516-3180.2021.0048.0904221Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trialMona Mohamed Tahahttps://orcid.org/0000-0001-9080-5061Ramy Salama Drazhttps://orcid.org/0000-0003-4089-323XMohamed Mostafa Gamalhttps://orcid.org/0000-0002-8067-304XZizi Mohamed Ibrahimhttps://orcid.org/0000-0001-6309-3484ABSTRACT BACKGROUND: Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS). OBJECTIVE: To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary complications (PPCs). DESIGN AND SETTING: Randomized controlled study conducted at Kasr Al-Ainy teaching hospital, Egypt. METHODS: A randomized controlled trial was conducted on 48 subjects undergoing elective UAS with high risk of developing PPCs. The study group received AD plus routine chest physiotherapy (deep diaphragmatic breathing, localized breathing and splinted coughing) and the control group received routine chest physiotherapy only. The outcomes included arterial blood gases measured at the first and seventh postoperative days, incidence of PPCs within the first seven days and length of hospital stay. RESULTS: Baseline characteristics were similar between groups. In the AD group, SaO2, PaO2, PaCO2 and HCO3 significantly improved (P < 0.05) while in the physiotherapy group, only SaO2 and PaO2 significantly improved (P < 0.05). Nonetheless, significant differences in post-treatment SaO2 and PaO2 between the groups were observed. The overall incidence of PPCs was 16.66% (12.5% in the AD group and 20.8% in the physiotherapy group) (absolute risk reduction -8.3%; 95% confidence interval, CI, -13.5 to 29.6%), with no significant difference between the groups. The AD group had a significantly shorter hospital stay (P = 0.0001). CONCLUSION: Adding AD to routine chest physiotherapy after UAS provided a favorable blood gas outcome and reduced the length of hospital stay. It tended to reduce the incidence of PPCs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04446520.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000600556&tlng=enBlood gas analysisPostoperative complicationsPhysical therapy modalitiesAutogenic drainageBlood gasesPulmonary complicationsPhysiotherapy techniquesUpper abdominal surgery |
| spellingShingle | Mona Mohamed Taha Ramy Salama Draz Mohamed Mostafa Gamal Zizi Mohamed Ibrahim Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial São Paulo Medical Journal Blood gas analysis Postoperative complications Physical therapy modalities Autogenic drainage Blood gases Pulmonary complications Physiotherapy techniques Upper abdominal surgery |
| title | Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial |
| title_full | Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial |
| title_fullStr | Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial |
| title_full_unstemmed | Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial |
| title_short | Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial |
| title_sort | adding autogenic drainage to chest physiotherapy after upper abdominal surgery effect on blood gases and pulmonary complications prevention randomized controlled trial |
| topic | Blood gas analysis Postoperative complications Physical therapy modalities Autogenic drainage Blood gases Pulmonary complications Physiotherapy techniques Upper abdominal surgery |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000600556&tlng=en |
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