Minder longcomplicaties door ademspiertraining bij patiënten die een coronaire bypassoperatie moeten ondergaan: een gerandomiseerde trial

E H J Hulzebos; P J M Helders; N J Favié; R A de Bie; A Brutel de la Rivière; N L U van Meeteren

Minder longcomplicaties door ademspiertraining bij patiënten die een coronaire bypassoperatie moeten ondergaan: een gerandomiseerde trial

Translated title of the contribution: Fewer lung complications following inspiratory muscle training in patients undergoing coronary bypass surgery: a randomized trial

E H J Hulzebos, P J M Helders, N J Favié, R A de Bie, A Brutel de la Rivière, N L U van Meeteren

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG).

DESIGN: Randomized controlled clinical trial (www.controlled-trials. com/isrctn17691887).

METHOD: Of 655 patients referred to a university medical centre in The Netherlands for elective CABG, 299 met the criteria for being at high risk of developing PPCs. A total of 279 were enrolled and monitored up to discharge from hospital. Patients were randomly assigned to receive either preoperative IMT (n=140) or usual care (n=139). Both groups received the same postoperative treatment.

RESULTS: Both groups were comparable at baseline. Before CABG, 2 control group patients and 1 IMT group patient died. After CABG surgery, PPCs were present in 25 (18%) of 139 patients in the IMT group and 48 (35%) of 137 patients in the control group (OR: 0.52; 95% CI: 0.30-0.92). Pneumonia occurred in 9 (6.5%) of 139 patients in the IMT group and in 22 (16.1%) of 137 patients in the usual care group (OR: 0.40; 95% CI: 0.19-0.84). Mean duration of postoperative hospitalization was 7 (range 5-41) days in the IMT group versus 8 (range 6-70) days in the usual care group (Mann-Whitney test; Z: -2.42; p = 0.015).

CONCLUSION: Preoperative physiotherapy, including IMT, statistically significantly reduced the incidence ofPPCs and the duration ofpostoperative hospitalization in patients at high risk of developing a pulmonary complication on undergoing CABG.

Translated title of the contribution	Fewer lung complications following inspiratory muscle training in patients undergoing coronary bypass surgery: a randomized trial
Original language	Dutch
Pages (from-to)	2505-11
Number of pages	7
Journal	Nederlands Tijdschrift voor Geneeskunde
Volume	151
Issue number	45
Publication status	Published - 10 Nov 2007

Keywords

Aged
Breathing Exercises
Coronary Artery Bypass
Cough
Female
Humans
Length of Stay
Male
Pleural Effusion
Pneumonia
Pneumothorax
Postoperative Complications
Preoperative Care
Respiratory Function Tests
Respiratory Tract Diseases
Risk Assessment
Single-Blind Method

Cite this

@article{e34aa725863249d78c1fea64cfe653d5,

title = "Minder longcomplicaties door ademspiertraining bij pati{\"e}nten die een coronaire bypassoperatie moeten ondergaan: een gerandomiseerde trial",

abstract = "OBJECTIVE: The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG).DESIGN: Randomized controlled clinical trial (www.controlled-trials. com/isrctn17691887).METHOD: Of 655 patients referred to a university medical centre in The Netherlands for elective CABG, 299 met the criteria for being at high risk of developing PPCs. A total of 279 were enrolled and monitored up to discharge from hospital. Patients were randomly assigned to receive either preoperative IMT (n=140) or usual care (n=139). Both groups received the same postoperative treatment.RESULTS: Both groups were comparable at baseline. Before CABG, 2 control group patients and 1 IMT group patient died. After CABG surgery, PPCs were present in 25 (18%) of 139 patients in the IMT group and 48 (35%) of 137 patients in the control group (OR: 0.52; 95% CI: 0.30-0.92). Pneumonia occurred in 9 (6.5%) of 139 patients in the IMT group and in 22 (16.1%) of 137 patients in the usual care group (OR: 0.40; 95% CI: 0.19-0.84). Mean duration of postoperative hospitalization was 7 (range 5-41) days in the IMT group versus 8 (range 6-70) days in the usual care group (Mann-Whitney test; Z: -2.42; p = 0.015).CONCLUSION: Preoperative physiotherapy, including IMT, statistically significantly reduced the incidence ofPPCs and the duration ofpostoperative hospitalization in patients at high risk of developing a pulmonary complication on undergoing CABG.",

keywords = "Aged, Breathing Exercises, Coronary Artery Bypass, Cough, Female, Humans, Length of Stay, Male, Pleural Effusion, Pneumonia, Pneumothorax, Postoperative Complications, Preoperative Care, Respiratory Function Tests, Respiratory Tract Diseases, Risk Assessment, Single-Blind Method",

author = "Hulzebos, {E H J} and Helders, {P J M} and Favi{\'e}, {N J} and {de Bie}, {R A} and {Brutel de la Rivi{\`e}re}, A and {van Meeteren}, {N L U}",

year = "2007",

month = nov,

day = "10",

language = "Dutch",

volume = "151",

pages = "2505--11",

journal = "Nederlands Tijdschrift voor Geneeskunde",

issn = "0028-2162",

publisher = "Bohn Stafleu van Loghum",

number = "45",

}

TY - JOUR

T1 - Minder longcomplicaties door ademspiertraining bij patiënten die een coronaire bypassoperatie moeten ondergaan

T2 - een gerandomiseerde trial

AU - Hulzebos, E H J

AU - Helders, P J M

AU - Favié, N J

AU - de Bie, R A

AU - Brutel de la Rivière, A

AU - van Meeteren, N L U

PY - 2007/11/10

Y1 - 2007/11/10

N2 - OBJECTIVE: The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG).DESIGN: Randomized controlled clinical trial (www.controlled-trials. com/isrctn17691887).METHOD: Of 655 patients referred to a university medical centre in The Netherlands for elective CABG, 299 met the criteria for being at high risk of developing PPCs. A total of 279 were enrolled and monitored up to discharge from hospital. Patients were randomly assigned to receive either preoperative IMT (n=140) or usual care (n=139). Both groups received the same postoperative treatment.RESULTS: Both groups were comparable at baseline. Before CABG, 2 control group patients and 1 IMT group patient died. After CABG surgery, PPCs were present in 25 (18%) of 139 patients in the IMT group and 48 (35%) of 137 patients in the control group (OR: 0.52; 95% CI: 0.30-0.92). Pneumonia occurred in 9 (6.5%) of 139 patients in the IMT group and in 22 (16.1%) of 137 patients in the usual care group (OR: 0.40; 95% CI: 0.19-0.84). Mean duration of postoperative hospitalization was 7 (range 5-41) days in the IMT group versus 8 (range 6-70) days in the usual care group (Mann-Whitney test; Z: -2.42; p = 0.015).CONCLUSION: Preoperative physiotherapy, including IMT, statistically significantly reduced the incidence ofPPCs and the duration ofpostoperative hospitalization in patients at high risk of developing a pulmonary complication on undergoing CABG.

AB - OBJECTIVE: The aim of this study was to evaluate the prophylactic efficacy of preoperative physiotherapy, including inspiratory muscle training (IMT), on the incidence of postoperative pulmonary complications (PPCs) in high-risk patients scheduled for elective coronary artery bypass grafting (CABG).DESIGN: Randomized controlled clinical trial (www.controlled-trials. com/isrctn17691887).METHOD: Of 655 patients referred to a university medical centre in The Netherlands for elective CABG, 299 met the criteria for being at high risk of developing PPCs. A total of 279 were enrolled and monitored up to discharge from hospital. Patients were randomly assigned to receive either preoperative IMT (n=140) or usual care (n=139). Both groups received the same postoperative treatment.RESULTS: Both groups were comparable at baseline. Before CABG, 2 control group patients and 1 IMT group patient died. After CABG surgery, PPCs were present in 25 (18%) of 139 patients in the IMT group and 48 (35%) of 137 patients in the control group (OR: 0.52; 95% CI: 0.30-0.92). Pneumonia occurred in 9 (6.5%) of 139 patients in the IMT group and in 22 (16.1%) of 137 patients in the usual care group (OR: 0.40; 95% CI: 0.19-0.84). Mean duration of postoperative hospitalization was 7 (range 5-41) days in the IMT group versus 8 (range 6-70) days in the usual care group (Mann-Whitney test; Z: -2.42; p = 0.015).CONCLUSION: Preoperative physiotherapy, including IMT, statistically significantly reduced the incidence ofPPCs and the duration ofpostoperative hospitalization in patients at high risk of developing a pulmonary complication on undergoing CABG.

KW - Aged

KW - Breathing Exercises

KW - Coronary Artery Bypass

KW - Cough

KW - Female

KW - Humans

KW - Length of Stay

KW - Male

KW - Pleural Effusion

KW - Pneumonia

KW - Pneumothorax

KW - Postoperative Complications

KW - Preoperative Care

KW - Respiratory Function Tests

KW - Respiratory Tract Diseases

KW - Risk Assessment

KW - Single-Blind Method

M3 - Article

C2 - 18062595

SN - 0028-2162

VL - 151

SP - 2505

EP - 2511

JO - Nederlands Tijdschrift voor Geneeskunde

JF - Nederlands Tijdschrift voor Geneeskunde

IS - 45

ER -

Minder longcomplicaties door ademspiertraining bij patiënten die een coronaire bypassoperatie moeten ondergaan: een gerandomiseerde trial

Abstract

Keywords

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