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A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery
L Denehy1, S Carroll, G Ntoumenopoulos
1School of Physiotherapy, University of Melbourne, Australia. l.denehy@physio.unimelb.edu.au
Summary
Adding periodic continuous positive airway pressure (PCPAP) to traditional physiotherapy after upper abdominal surgery did not significantly improve patient outcomes. Further research is needed to optimize post-operative pulmonary care.
Area of Science:
- Respiratory Therapy
- Surgical Recovery
- Clinical Trials
Background:
- Post-operative pulmonary complications are a concern after upper abdominal surgery.
- Traditional physiotherapy is a common intervention to improve lung function.
- The optimal application of periodic continuous positive airway pressure (PCPAP) remains unclear.
Purpose of the Study:
- To compare the effects of two dosages of PCPAP with traditional physiotherapy on post-operative outcomes.
- To evaluate the impact of PCPAP on functional residual capacity (FRC), vital capacity (VC), and oxyhaemoglobin saturation (SpO2).
- To assess the incidence of post-operative pulmonary complications and length of hospital stay.
Main Methods:
- A randomized controlled trial involving 57 subjects undergoing elective upper abdominal surgery.
- Subjects were allocated to three groups: traditional physiotherapy alone, or traditional physiotherapy with 15 or 30 minutes of PCPAP, four times daily for three days.
- Key physiological and clinical outcomes were measured post-operatively.
Main Results:
- No significant differences in FRC, VC, or SpO2 were observed between the groups.
- The incidence of post-operative pulmonary complications was lower in the PCPAP groups (11% and 6%) compared to the control group (22%).
- Length of hospital stay was not significantly different between groups, although complications prolonged stays.
Conclusions:
- The addition of PCPAP to traditional physiotherapy did not significantly improve physiological or clinical outcomes in this study.
- While a trend towards reduced pulmonary complications was observed with PCPAP, it did not reach statistical significance.
- The findings suggest that current PCPAP protocols may not offer substantial benefits over traditional physiotherapy alone for this patient population.