Self-administered prophylactic postoperative positive expiratory pressure in thoracic surgery

Area of Science:

• Thoracic Surgery
• Respiratory Physiotherapy
• Pulmonary Complications

Background:

• Thoracotomy patients are at risk for postoperative pulmonary complications like atelectasis.
• Conventional physiotherapy is standard care, but adjunct therapies are explored to improve outcomes.

Purpose of the Study:

• To investigate the efficacy of self-administered positive expiratory pressure (S-PEP) in preventing atelectasis post-thoracotomy.
• To compare S-PEP therapy combined with physiotherapy against physiotherapy alone.

Main Methods:

• A randomized controlled trial involving 75 patients undergoing thoracotomy.
• Patients were divided into an S-PEP group (n=29) using a resistance device and a control group (n=27) without resistance.
• Treatment and observation period lasted for 3 postoperative days.

Main Results:

• Radiographic atelectasis occurred in 13 S-PEP patients versus 8 control patients (P > 0.05).
• Postoperative PaO2 was 0.36 kPa lower in the S-PEP group compared to the control group (P > 0.05).
• No statistically significant difference in atelectasis or blood gas tensions was observed between groups.

Conclusions:

• S-PEP therapy, when added to conventional physiotherapy, did not demonstrate a beneficial effect in preventing postoperative atelectasis after thoracotomy.
• Current evidence suggests S-PEP is not effective for this patient population based on radiographic and blood gas assessments.