医学
随机对照试验
肺活量
到期
心脏外科
麻醉
置信区间
肺功能测试
机械通风
外科
心胸外科
内科学
呼吸系统
肺
肺功能
扩散能力
作者
Xiaoyu Chen,Lin Hou,Yuanyuan Zhang,Xiangjing Liu,Bohan Shao,Bo Yuan,Jing Li,Min Li,Hong Cheng,Lichen Teng,Man Guo,Zhengqing Wang,Tienan Chen,Jianjun Liu,Yaping Liu,Zhigang Liu,Xiaocheng Liu,Qi Guo
标识
DOI:10.1177/0269215519828212
摘要
To determine the prophylactic efficacy of short-term intensive preoperative inspiratory muscle training on the incidence of postoperative pulmonary complications in patients scheduled for cardiac surgery.Single-blind, randomized controlled pilot study.TEDA International Cardiovascular Hospital, China.In total, 197 subjects aged ⩾50 years scheduled for cardiac surgery were selected.The intervention group ( n = 98) received five days of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group ( n = 99).The primary outcome variable was the occurrence of postoperative pulmonary complications. The secondary outcome variables were inspiratory muscle strength, lung function and length of hospitalization.After cardiac surgery, a total of 10 (10.2%) of the 98 patients in the intervention group and 27 (27.3%) of 99 patients in the control group had postoperative pulmonary complications (risk ratio, 0.23; 95% confidence interval (CI), 0.09-0.58, P = 0.002). The study revealed that, compared with the control group, the intervention group had a significant increase in inspiratory muscle strength (by 10.48 cm H2O, P < 0.001), forced expiratory volume in the first second of expiration (FEV1) %predicted (by 3.75%, P = 0.030), forced vital capacity (FVC) %predicted (by 4.15%, P = 0.008) and maximal voluntary ventilation (MVV) %predicted (by 6.44%, P = 0.034). Length of hospital stay was 7.51 (2.83) days in the intervention group and 9.38 (3.10) days in the control group ( P = 0.039).A five-day intensive pattern of preoperative inspiratory muscle training reduced the incidence of postoperative pulmonary complications and duration of postoperative hospitalization in patients undergoing cardiac surgery.
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