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Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial
Taha, Mona Mohamed; Draz, Ramy Salama; Gamal, Mohamed Mostafa; Ibrahim, Zizi Mohamed.
  • Taha, Mona Mohamed; Princess Nourah bint Abdulrahman University. College of Health and Rehabilitation Sciences. Department of Rehabilitation. Riyadh. SA
  • Draz, Ramy Salama; Cairo University. Faculty of Physical Therapy. Department of Cardiovascular/Respiratory Disorders and Geriatrics. Cairo. EG
  • Gamal, Mohamed Mostafa; Kasr Al-Ainy Teaching Hospital. Giza. EG
  • Ibrahim, Zizi Mohamed; Cairo University. Faculty of Physical Therapy. Department of Surgery. Cairo. EG
São Paulo med. j ; 139(6): 556-563, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1352293
ABSTRACT
ABSTRACT

BACKGROUND:

Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS).

OBJECTIVE:

To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary complications (PPCs). DESIGN AND

SETTING:

Randomized controlled study conducted at Kasr Al-Ainy teaching hospital, Egypt.

METHODS:

A randomized controlled trial was conducted on 48 subjects undergoing elective UAS with high risk of developing PPCs. The study group received AD plus routine chest physiotherapy (deep diaphragmatic breathing, localized breathing and splinted coughing) and the control group received routine chest physiotherapy only. The outcomes included arterial blood gases measured at the first and seventh postoperative days, incidence of PPCs within the first seven days and length of hospital stay.

RESULTS:

Baseline characteristics were similar between groups. In the AD group, SaO2, PaO2, PaCO2 and HCO3 significantly improved (P < 0.05) while in the physiotherapy group, only SaO2 and PaO2 significantly improved (P < 0.05). Nonetheless, significant differences in post-treatment SaO2 and PaO2 between the groups were observed. The overall incidence of PPCs was 16.66% (12.5% in the AD group and 20.8% in the physiotherapy group) (absolute risk reduction -8.3%; 95% confidence interval, CI, -13.5 to 29.6%), with no significant difference between the groups. The AD group had a significantly shorter hospital stay (P = 0.0001).

CONCLUSION:

Adding AD to routine chest physiotherapy after UAS provided a favorable blood gas outcome and reduced the length of hospital stay. It tended to reduce the incidence of PPCs. TRIAL REGISTRATION ClinicalTrials.gov NCT04446520.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Physical Therapy Modalities / Elective Surgical Procedures Type of study: Controlled clinical trial Limits: Humans Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2021 Type: Article Affiliation country: Egypt / Saudi Arabia Institution/Affiliation country: Cairo University/EG / Kasr Al-Ainy Teaching Hospital/EG / Princess Nourah bint Abdulrahman University/SA

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Full text: Available Index: LILACS (Americas) Main subject: Physical Therapy Modalities / Elective Surgical Procedures Type of study: Controlled clinical trial Limits: Humans Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2021 Type: Article Affiliation country: Egypt / Saudi Arabia Institution/Affiliation country: Cairo University/EG / Kasr Al-Ainy Teaching Hospital/EG / Princess Nourah bint Abdulrahman University/SA