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Preoperative physiotherapy in prevention of pulmonary complications in pediatric cardiac surgery

Josiane Marques Felcar1, José Carlos dos Santos Guitti, Antônio César Marson

  • 1Departamento de Fisioterapia, UNOPAR. josianefelcar@sercomtel.com.br

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|December 17, 2008
PubMed

Insights

Preoperative physiotherapy significantly reduces pulmonary complications in children after cardiac surgery. This intervention lowers the risk of pneumonia and atelectasis, improving patient outcomes.

Area of Science:

  • Pediatric Cardiac Surgery
  • Respiratory Physiotherapy
  • Congenital Heart Disease

Background:

  • Pulmonary complications are a significant concern in pediatric patients undergoing cardiac surgery.
  • Current interventions often focus solely on postoperative care, potentially missing opportunities for early risk mitigation.

Purpose of the Study:

  • To evaluate the effectiveness of pre- and postoperative physiotherapy in reducing pulmonary complications in pediatric cardiac surgery patients.
  • To compare outcomes between patients receiving both pre- and postoperative physiotherapy versus those receiving only postoperative physiotherapy.

Main Methods:

  • A randomized controlled trial involving 135 pediatric patients (≤6 years) with congenital heart disease undergoing cardiac surgery.
  • Patients were assigned to either pre- and postoperative physiotherapy (G1) or postoperative physiotherapy alone (G2).
  • Statistical analyses included Mann-Whitney and Chi-square tests; absolute risk reduction and number needed to treat were calculated.

Main Results:

  • A significantly lower incidence of pulmonary complications was observed in the pre- and postoperative physiotherapy group (G1) compared to the postoperative-only group (G2) (25% vs. 43.3%, P=0.025).
  • Pneumonia and atelectasis were the most common complications, with G1 showing fewer cases of each.
  • The absolute risk reduction for pulmonary complications was 18.3%, with a number needed to treat of 5.5.

Conclusions:

  • Preoperative respiratory physiotherapy is a crucial intervention for reducing the risk of pulmonary complications in pediatric patients following cardiac surgery.
  • Integrating preoperative physiotherapy into care pathways can lead to improved postoperative respiratory health in this vulnerable population.
Abstract

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