Related Experiment Video
Updated: May 28, 2025
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Current practice of targeted breathing exercises after abdominal and cardiothoracic surgery: a national multicentre
Monika Fagevik Olsén1, Anna Svensson-Raskh2, Elisabeth Westerdahl3
1Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Objectives:
To describe the timing and type of the first targeted breathing exercises after abdominal and cardiothoracic surgery, and to identify factors associated with early initiation (Commencement within three hours after arriival to a postoperative ward).
Design:
Multicentre observational study.
Methods:
In 18 hospitals in Sweden, the start time and type of targeted breathing exercises were recorded in consecutive series of patients who underwent abdominal or cardiothoracic surgery. Demographic data were retrieved from hospital records. Patients were divided into seven groups based on the category of surgery.
Results:
In total, 1492 patients were included in this study; of these, 1128 (76%) performed some form of targeted breathing exercise after surgery. Targeted breathing exercises commenced a median of 3.63 hours (interquartile range 1.58 to 11.75 hours) after arrival on a postoperative ward, with earlier commencement after minor abdominal surgery and later commencement after major abdominal surgery (P < 0.001). Most patients who performed targeted breathing exercises used positive expiratory pressure (n = 968/1492, 65%) or deep breathing without any devices (n = 207/1492, 14%). The odds of initiating breathing exercises within the first 3 hours after arrival on a postoperative ward were higher if a patient underwent pulmonary or abdominal surgery [odds ratio (OR) > 2.04; P < 0.001], or had intravenous analgesia (OR 1.50, 95% CI 1.05 to 2.14; P = 0.026). The odds were lower (OR 0.43, 95% CI 0.21 to 0.88; P = 0.021) for patients who arrived on the postoperative ward in the evening/night or for patients who had undergone laparoscopic surgery (OR 0.63, 0.43-0.92, p=0.018).
Conclusion:
The majority (76%) of patients undergoing abdominal or cardiothoracic surgery performed some form of targeted breathing exercise, starting a median of 3.63 hours after arrival on a postoperative ward.
Trial Registration:
"FoU in Sweden" (Research and Development in Sweden) ID: 275357 and Clinical Trials NCT04729634. CONTRIBUTION OF THE PAPER.
Related Concept Videos
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:27Pneumothorax-II
Clinical Manifestations:
01:24Chest Physiotherapy
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
01:21Mechanism of Breathing III: The Accessory Muscles
The respiratory system is a complex network that relies on primary respiratory muscles like the diaphragm, but also involves accessory muscles to enhance lung expansion and airflow during both inhalation and exhalation.
Enhancing Inhalation with Accessory Muscles:
Accessory muscles such as the sternocleidomastoid, scalene, intercostal, and abdominal muscles are crucial when additional respiratory effort is required, such as during deep...
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...