[Prevention of postoperative pulmonary complications by preoperative training]

Postoperative pulmonary complications are the main cause of morbidity and mortality after surgery. A likely explanation is dysfunction of the respiratory muscles, in particular the diaphragm, which results in rapid, shallow breathing and ultimately-in closing of the airways, atelectasis and hypoxaemia. Breathing exercises in the perioperative period, despite a good rationale, were in general not found to be effective. A promising new approach is specific training of inspiratory muscles. A randomized clinical trial, published in this issue of the journal, found this to be effective in patients at increased risk for postoperative complications who underwent cardiac surgery.