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Year 2014, , 57 - 67, 16.02.2015

Alis Kostanoğlu , Ela Tarakcı , Enver Dayıoğlu Sabriye Demirci

https://doi.org/10.17681/hsp.04660

Abstract

Abstrac Aim: Investigating effects of Incentive Spirometry and Continuous Positive Airway Pressure (CPAP) masks on postoperative pulmonary complications in patients who were undergone thoracicsurgery. Material and Methods: The study enrolled totally 30 patients, including 14 female and 16 male patients, who were hemodynamically stable following thoracic surgery. Following the extubation, patients were randomly divided into two groups. “Incentive Spirometry” studies were performed with group 1, while “CPAP” studies were performed with group 2. For all cases, arterial blood gases analysis, respiratory functions tests and pulmonary X-ray examinations were performed at post- operative first and ninth days. Results: Following the onset of study, no difference could be found in arterial blood gases results performed at post-operative first and ninth days (p>0.05). In both groups, statistically significant decrease in Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and Forced Expiratory Flow values measured at post-operative ninth days was found in comparison with pre-operative measurement values (p<0.001). However, pulmonary function tests were compared postoperative first the ninth days and significant improvements in both groups began ninth day (p<0.001). It was observed that the improvement found in all parameters of respiratory function tests did not have statistically significant differences (p>0.05). In the pulmonary X-ray examination, there was not statistically significant difference between two groups following the therapy (p>0.05). Conclusion: Mechanic physiotherapy techniques are efficient for improving respiratory performance in patients who are undergoing thoracic surgery. Incentive Spirometry and CPAP are not superior to each other on preventing pulmonary complications

Keywords

Thoracic surgery; Incentive Spirometry; Positive Airway Pressure; pulmonary function tests; physiotherapy

References

  • KAYNAKLAR
  • Ferguson MK. Preoperative assessment of pulmonary risk. Chest 1999;115: 58-63.
  • Hall JC, Talala RA, Mander J. A multivariate analysis of the risk of pulmonary complications after laparatomy. Chest 1991;99:923-7.
  • Brooks JA, Brunn DNS. Predictors of postoperative pulmonary complications following abdominal surgery. Chest 1997;111:564-71.
  • Ferreyra G, Long Y, Ranieri VM. Respiratory complications after major surgery. Current Opinion in Critical Care 2009;15:342–8.
  • Stéphan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, et al. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest 2000;118(5):1263-70.
  • Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat MS, Rajesh PB, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax 2010;65:815-8.
  • Eagle KA, Guyton RA, Davidiff R, Edwards FH, EwyGA, Fonger J, Gardner TJ, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: Summary article. J Am Coll Cardio, 2004; 44:1146-54.
  • Berry CB, Butler PJ, Myles PS. Lung management during cardiopulmonary bypass: is continuous positive airways pressure beneficial? Br J Anaesth 1993;71(6):864-8.
  • Dyhr T, Laursen N, Larsson A. Effects of lung recruitment maneuver and positive end-expiratory pressure on lung volume, respiratory mechanics and alveolar gas mixing in patients ventilated after cardiac surgery. Acta Anaesthesiol Scand. 2002;46(6):717-25.
  • Allen MS, Darling GE, Pechet TT, Mitchell JD, Herndon JE, Landreneau RJ, et al; ACOSOG Z0030 Study Group. Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg 2006;81:1013-20.
  • Garcia Miguel FJ, Serrano-Aguilar PG, Lopez-Bastida J. Preoperative assessment. Lancet 2003;362:1749–59.
  • Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg 1992; 54:84–8.
  • Renault JA, Costa-Val R, Rossetti MB. Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery. Rev Bras Cir Cardiovasc 2008;23:562-9.
  • Savci S, Sakin S, Inal Ince D, Arikan H, Can Z, Buran Y, Kuralay E. Active cycle of breathing techniques and incentive spirometer in coronary artery bypass graft surgery. Fizyoterapi Rehabilitasyon 2006;17:61-9.
  • Brooks D, Crowe J, Kelsey CJ, Lacy JB, Parsons J, Solway S. A clinical practice guideline on peri-operative cardiorespiratory physical therapy. Physiotherapy Canada 2001;53(1):9–25.
  • Tusman G, Bohm SH, Tempra A, Melkun F, Garcia E, Turchetto E, Mulder PG, Lachmann B: Effects of recruitment maneuver on atelectasis in anesthetized children. Anesthesiology 2003; 98:14–22
  • Berrizbeitia LD, Tessler S, Jacobowitz IJ,et al. Effect of sternotomy and coronary bypass surgery on postoperative pulmonary mechanics: Comparison of internal mammary and saphenous vein bypass grafts. Chest 1989:96;873-6.
  • Kindgen-Milles D, Buhl R, Gabriel A, Böhner H and Müler. Nasal Continuous Positive Airway Pressure A Method to Avoid Endotracheal Reintubation in Postoperative High-risk Patients With Severe Nonhypercapnic Oxygenation Failure. Chest 2000;117:1106-11.
  • Ricksten SE, Bengtsson A, Soderberg C, Thorden M, Kvist H. Effects of periodic positive airway pressure by mask on postoperative pulmonary function. Chest 1986;89: 774-81.
  • Overend T J, Anderson MA, Lucy SD, Bhatia C,Jonsson BI, Timmermans C. The Effect of Incentive Spirometry on Postoperative Pulmonary Complications.A Systematic Review. Chest 2001;120(3):971-8.
  • Gürses HN. Peroperatif rehabilitasyon, Kronik solunum yetersizliğinde solunum pompa desteği. Solunum 2002;4: 332-8.
  • Sarkıç S. Açık kalp ameliyatı geçiren hastalarda İnsentif Spirometre ile aktif solunum teknikleri döngüsünün etkinliğinin karşılaştırılması. Kardiyopulmoner Rehabilitasyon programı yüksek lisans tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara, 2004.
  • Varela G, Ballesteros E, Jimenez MF, Novoa N, Aranda JL. Cost effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy. Eur J Cardiothorac Surg 2006;29:216–20.
  • Braun SR, Brinbaum ML, ChoprA PS. Pre and postoperative pulmonary function abnormalities in coronary artery revascularization surgey. Chest 1978;73:316-20.

Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)'ın karşılaştırılması

Year 2014, , 57 - 67, 16.02.2015

Alis Kostanoğlu , Ela Tarakcı , Enver Dayıoğlu Sabriye Demirci

https://doi.org/10.17681/hsp.04660

Abstract

Amaç: Torasik cerrahi geçiren hastalarda İnsentif spirometre ve
devamlı pozitif havayolu basıncı- Continuous Positive Airway
Pressure maskesinin postoperatif pulmoner komplikasyonlar
üzerine etkisinin araştırılması. Gereç ve Yöntemler: Çalışmaya
torasik cerrahi geçiren hemodinamik açıdan stabil, yaşları 16-75
arasında değişen 14’ü kadın, 16’sı erkek toplam 30 hasta dahil
edildi. Hastalar ekstübasyonu takiben randomize olarak iki gruba
ayrıldı. 1. grupla “İnsentif Spirometre” çalışmaları, 2. grupla ise
“CPAP uygulaması” yapıldı. Tüm olguların postoperatif birinci
ve dokuzuncu günde arter kan gazları, solunum fonksiyon
testleri ve akciğer radyolojik incelemesi yapıldı ve sonuçlar
karşılaştırıldı. Bulgular: Olgularla çalışmaya başlandıktan sonra
postoperatif birinci ve dokuzuncu günde yapılan arter kan gazı
sonuçları gruplar arası farklı bulunmadı (p > 0.05) Her iki
gruptaki hastaların Zorlu Vital Kapasite-Forced Vital Capacity
(FVC), birinci saniyede Zorlu Ekspirasyon Volümü-Forced
Expiratory Volume 1 second (FEV1), ve Zorlu Eksipratuar
Akım-Forced Expiratory Flow (FEF %25-75) değerlerinde
postoperatif dokuzuncu günde preoperatif ölçüm değerlerine
göre istatistiksel olarak anlamlı düzeyde azalmalar tespit edildi
(p < 0.001). Ancak postoperatif birinci gün ile dokuzuncu gün
solunum fonksiyon testleri karşılaştırıldığında ise dokuzuncu
günde her iki gurupta da anlamlı düzelmeler başladı (p < 0.001).
Solunum fonksiyon testlerinin tüm parametrelerinde gözlenen bu
düzelmenin gruplar arasında istatistiksel olarak anlamlı fark
oluşturmadığı görüldü (p > 0.05). Akciğer radyolojik
incelemesinde de tedavi sonrası iki grup arasında istatistiksel
olarak anlamlı fark mevcut değildi (p > 0.05). Sonuç: Torasik
cerrahi geçiren hastalarda solunum performansını geliştirmek
için mekanik fizyoterapi teknikleri etkilidir. İnsentif Spirometre
ve CPAP uygulamasının pulmoner komplikasyonları önleme
açısından birbirlerine üstünlükleri yoktur.

Keywords

Toraks cerrahisi insentif spirometre Continuous positive airway pressure solunum fonksiyon testleri fizyoterapi

References

  • KAYNAKLAR
  • Ferguson MK. Preoperative assessment of pulmonary risk. Chest 1999;115: 58-63.
  • Hall JC, Talala RA, Mander J. A multivariate analysis of the risk of pulmonary complications after laparatomy. Chest 1991;99:923-7.
  • Brooks JA, Brunn DNS. Predictors of postoperative pulmonary complications following abdominal surgery. Chest 1997;111:564-71.
  • Ferreyra G, Long Y, Ranieri VM. Respiratory complications after major surgery. Current Opinion in Critical Care 2009;15:342–8.
  • Stéphan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, et al. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest 2000;118(5):1263-70.
  • Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat MS, Rajesh PB, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax 2010;65:815-8.
  • Eagle KA, Guyton RA, Davidiff R, Edwards FH, EwyGA, Fonger J, Gardner TJ, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: Summary article. J Am Coll Cardio, 2004; 44:1146-54.
  • Berry CB, Butler PJ, Myles PS. Lung management during cardiopulmonary bypass: is continuous positive airways pressure beneficial? Br J Anaesth 1993;71(6):864-8.
  • Dyhr T, Laursen N, Larsson A. Effects of lung recruitment maneuver and positive end-expiratory pressure on lung volume, respiratory mechanics and alveolar gas mixing in patients ventilated after cardiac surgery. Acta Anaesthesiol Scand. 2002;46(6):717-25.
  • Allen MS, Darling GE, Pechet TT, Mitchell JD, Herndon JE, Landreneau RJ, et al; ACOSOG Z0030 Study Group. Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg 2006;81:1013-20.
  • Garcia Miguel FJ, Serrano-Aguilar PG, Lopez-Bastida J. Preoperative assessment. Lancet 2003;362:1749–59.
  • Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg 1992; 54:84–8.
  • Renault JA, Costa-Val R, Rossetti MB. Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery. Rev Bras Cir Cardiovasc 2008;23:562-9.
  • Savci S, Sakin S, Inal Ince D, Arikan H, Can Z, Buran Y, Kuralay E. Active cycle of breathing techniques and incentive spirometer in coronary artery bypass graft surgery. Fizyoterapi Rehabilitasyon 2006;17:61-9.
  • Brooks D, Crowe J, Kelsey CJ, Lacy JB, Parsons J, Solway S. A clinical practice guideline on peri-operative cardiorespiratory physical therapy. Physiotherapy Canada 2001;53(1):9–25.
  • Tusman G, Bohm SH, Tempra A, Melkun F, Garcia E, Turchetto E, Mulder PG, Lachmann B: Effects of recruitment maneuver on atelectasis in anesthetized children. Anesthesiology 2003; 98:14–22
  • Berrizbeitia LD, Tessler S, Jacobowitz IJ,et al. Effect of sternotomy and coronary bypass surgery on postoperative pulmonary mechanics: Comparison of internal mammary and saphenous vein bypass grafts. Chest 1989:96;873-6.
  • Kindgen-Milles D, Buhl R, Gabriel A, Böhner H and Müler. Nasal Continuous Positive Airway Pressure A Method to Avoid Endotracheal Reintubation in Postoperative High-risk Patients With Severe Nonhypercapnic Oxygenation Failure. Chest 2000;117:1106-11.
  • Ricksten SE, Bengtsson A, Soderberg C, Thorden M, Kvist H. Effects of periodic positive airway pressure by mask on postoperative pulmonary function. Chest 1986;89: 774-81.
  • Overend T J, Anderson MA, Lucy SD, Bhatia C,Jonsson BI, Timmermans C. The Effect of Incentive Spirometry on Postoperative Pulmonary Complications.A Systematic Review. Chest 2001;120(3):971-8.
  • Gürses HN. Peroperatif rehabilitasyon, Kronik solunum yetersizliğinde solunum pompa desteği. Solunum 2002;4: 332-8.
  • Sarkıç S. Açık kalp ameliyatı geçiren hastalarda İnsentif Spirometre ile aktif solunum teknikleri döngüsünün etkinliğinin karşılaştırılması. Kardiyopulmoner Rehabilitasyon programı yüksek lisans tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara, 2004.
  • Varela G, Ballesteros E, Jimenez MF, Novoa N, Aranda JL. Cost effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy. Eur J Cardiothorac Surg 2006;29:216–20.
  • Braun SR, Brinbaum ML, ChoprA PS. Pre and postoperative pulmonary function abnormalities in coronary artery revascularization surgey. Chest 1978;73:316-20.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section RESEARCH ARTICLE
Authors

Alis Kostanoğlu

Ela Tarakcı

Enver Dayıoğlu This is me

Sabriye Demirci This is me

Publication Date February 16, 2015
Published in Issue Year 2014

Cite

APA Kostanoğlu, A., Tarakcı, E., Dayıoğlu, E., Demirci, S. (2015). Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması. Sağlık Bilimleri Ve Meslekleri Dergisi, 1(2), 57-67. https://doi.org/10.17681/hsp.04660
AMA Kostanoğlu A, Tarakcı E, Dayıoğlu E, Demirci S. Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması. HSP. February 2015;1(2):57-67. doi:10.17681/hsp.04660
Chicago Kostanoğlu, Alis, Ela Tarakcı, Enver Dayıoğlu, and Sabriye Demirci. “Torasik Cerrahi Sonrası Postoperatif Pulmoner komplikasyonların önlenmesinde İnsentif Spirometre Ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması”. Sağlık Bilimleri Ve Meslekleri Dergisi 1, no. 2 (February 2015): 57-67. https://doi.org/10.17681/hsp.04660.
EndNote Kostanoğlu A, Tarakcı E, Dayıoğlu E, Demirci S (February 1, 2015) Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması. Sağlık Bilimleri ve Meslekleri Dergisi 1 2 57–67.
IEEE A. Kostanoğlu, E. Tarakcı, E. Dayıoğlu, and S. Demirci, “Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması”, HSP, vol. 1, no. 2, pp. 57–67, 2015, doi: 10.17681/hsp.04660.
ISNAD Kostanoğlu, Alis et al. “Torasik Cerrahi Sonrası Postoperatif Pulmoner komplikasyonların önlenmesinde İnsentif Spirometre Ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması”. Sağlık Bilimleri ve Meslekleri Dergisi 1/2 (February 2015), 57-67. https://doi.org/10.17681/hsp.04660.
JAMA Kostanoğlu A, Tarakcı E, Dayıoğlu E, Demirci S. Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması. HSP. 2015;1:57–67.
MLA Kostanoğlu, Alis et al. “Torasik Cerrahi Sonrası Postoperatif Pulmoner komplikasyonların önlenmesinde İnsentif Spirometre Ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması”. Sağlık Bilimleri Ve Meslekleri Dergisi, vol. 1, no. 2, 2015, pp. 57-67, doi:10.17681/hsp.04660.
Vancouver Kostanoğlu A, Tarakcı E, Dayıoğlu E, Demirci S. Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)’ın karşılaştırılması. HSP. 2015;1(2):57-6.