Journal of Korean Academy of Fundamentals of Nursing (기본간호학회지)

Korean Academy of Fundamentals of Nursing (기본간호학회)
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Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review

수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰

  • Lee, Worlsook (National Evidence-based Healthcare Collaborating Agency, Graduate School, College of Nursing, Yonsei University) ;
  • Yang, You Lee (Graduate School, College of Nursing, Yonsei University) ;
  • Oh, Eui Geum (Nursing Policy Research Institute, College of Nursing, Yonsei University)
  • 이월숙 (한국보건의료연구원/연세대학교 간호대학) ;
  • 양유리 (연세대학교 간호대학) ;
  • 오의금 (연세대학교 간호대학, 간호정책연구소)
  • Received : 2014.07.23
  • Accepted : 2014.10.16
  • Published : 2014.11.30
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Abstract

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

Keywords

References

  1. Centers for Disease Control and Prevention. Inpatient surgery [Internet]. US: Centers for Disease Control and Prevention; 2012 [cited 2013 July 10]. Available from: http://www.cdc.gov/nchs/fastats/inpatient-surgery.htm.
  2. National Health Interview Survey. Statistical brief of major surgery 2011 [Internet]. Korea: National Health Interview Survey; 2012 [cited 2013 July 10]. Available from: http://stat.mw.go.kr/front/include/download.jsp?bbsSeq=4&nttSeq=20362&atchSeq=3399.
  3. Reimer-Kent J. Creating a postoperative wellness model to optimize and enhance rapid surgical recovery. Canadian Journal of Cardiovascular Nursing. 2012;22(2):7-23.
  4. Canet J, Gallart L. Postoperative respiratory failure: Pathogenesis, prediction, and prevention. Current Opinion in Critical Care. 2014;20(1):56-62. http://dx.doi.org/10.1097/MCC.0000000000000045
  5. Garcia-Miguel FJ, Serrano-Aguilar PG, Lopez-Bastida J. Preoperative assessment. Lancet. 2003;362(9397):1749-1757. https://doi.org/10.1016/S0140-6736(03)14857-X
  6. Manzano RM, Carvalho CR, Saraiva-Romanholo BM, Vieira JE. Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: Randomized clinical trial. Sao Paulo Medical Journal. 2008;126(5):269-273. https://doi.org/10.1590/S1516-31802008000500005
  7. Branson RD. The scientific basis for postoperative respiratory care. Respiratory Care. 2013;58(11):1974-1984. http://dx.doi.org/10.4187/respcare.02832
  8. Overend TJ, Anderson CM, Lucy SD, Bhatia C, Jonsson BI, Timmermans C. The effect of incentive spirometry on postoperative pulmonary complications: A systematic review. Chest. 2001;120(3):971-978. https://doi.org/10.1378/chest.120.3.971
  9. Pasquina P, Tramer MR, Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: Systematic review. British Medical Journal. 2003;327(7428):1379-1381. https://doi.org/10.1136/bmj.327.7428.1379
  10. do Nascimento Junior P, Modolo NS, Andrade S, Guimaraes MM, Braz LG, EI Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database of Systematic Reviews. 2014;8(2):CD006058. http://dx.doi.org/10.1002/14651858.CD006058.pub3
  11. Thanavaro JL, Foner BJ. Postoperative pulmonary complications: Reducing risks for noncardiac surgery. Nurse Practitional. 2013;38(7):38-47. http://dx.doi.org/10.1097/01.NPR.0000431179.49311.0b
  12. Chailler M, Ellis J, Stolarik A, Woodend K. Cold therapy for the management of pain associated with deep breathing and coughing post-cardiac surgery. Canadian Journal of Cardiovascular Nursing. 2010;20(2):18-24.
  13. Mackay MR, Ellis E, Johnston C. Randomized clinical trial of physiotherapy after open abdominal surgery in high risk patients. Australian Journal of Physiotherapy. 2005;51(3):151-159. https://doi.org/10.1016/S0004-9514(05)70021-0
  14. Reeve JC, Nicol K, Stiller K, McPherson KM, Birch P, Gordon IR, et al. Does physiotherapy reduce the incidence of postoperative pulmonary complications following pulmonary resection via open thoracotomy? A preliminary randomized single-blind clinical trial. European Journal of Cardio-thoracic Surgery. 2010;37(5):1158-1166. http://dx.doi.org/10.1016/j.ejcts.2009.12.011
  15. Genc A, Ikiz AO, Guneri EA, Gunerli A. Effect of deep breathing exercises on oxygenation after major head and neck surgery. Otolaryngology Head and Neck Surgery. 2008;139(2):281-285. http://dx.doi.org/10.1016/j.otohns.2008.04.025
  16. Urell C, Emtner M, Hedenstrom H, Tenling A, Breidenskog M, Westerdahl E. Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery--A randomised controlled trial. European Journal of Cardio-thoracic Surgery. 2011;40(1):162-167. http://dx.doi.org/10.1016/j.ejcts.2010.10.018
  17. Westerdahl E, Lindmark B, Eriksson T, Friberg O, Hedenstierna G, Tenling A. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128(5):3482-3488. https://doi.org/10.1378/chest.128.5.3482
  18. Grams ST, Ono LM, Noronha MA, Schivinski CI, Paulin E. Breathing exercises in upper abdominal surgery: A systematic review and meta-analysis. Revista Brasileira de Fisioterapia. 2012;16(5):345-353. http://dx.doi.org/10.1590/S1413-35552012005000052
  19. Hall JC, Tarala RA, Tapper J, Hall JL. Prevention of respiratory complications after abdominal surgery: A randomised clinical trial. British Medical Journal. 1996;312(7024):148-152. https://doi.org/10.1136/bmj.312.7024.148
  20. Stiller K, Montarello J, Wallace M, Daff M, Grant R, Jenkins S, et al. Efficacy of breathing and coughing exercises in the prevention of pulmonary complications after coronary artery surgery. Chest. 1994;105(3): 741-747. https://doi.org/10.1378/chest.105.3.741
  21. Fagevik Olsen M, Hahn I, Nordgren S, Lonroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. British Journal of Surgery. 1997; 84(11):1535-1538. https://doi.org/10.1002/bjs.1800841111
  22. Chumillas S, Ponce JL, Delgado F, Viciano V, Mateu M. Prevention of postoperative pulmonary complications through respiratory rehabilitation: A controlled clinical study. Archives of Physical Medicine and Rehabilitation. 1998;79(1):5-9. https://doi.org/10.1016/S0003-9993(98)90198-8
  23. Brasher PA, McClelland KH, Denehy L, Story I. Does removal of deep breathing exercises from a physiotherapy program including pre-operative education and early mobilisation after cardiac surgery alter patient outcomes?. Australian Journal of Physiotherapy. 2003;49(3):165-173. https://doi.org/10.1016/S0004-9514(14)60236-1
  24. Renault JA, Costa-Val R, Rossetti MB, Houri Neto M. Comparison between deep breathing exercises and incentive spirometry after CABG surgery. Revista Brasileira de Cirurgia Cardiovascular. 2009;24(2):165-172. https://doi.org/10.1590/S0102-76382009000200012
  25. de Charmoy SB, Eales CJ. The role of prophylactic chest physiotherapy after cardiac valvular surgery: Is there one?. South African Journal of Physiotherapy. 2000;56(3):24-28.
  26. Lim C, Cho H, Chang SH. The effect of deep breathing exercise and incentive spirometry to prevent postoperative pulmonary complications after abdominal surgery in geriatric patients. Korean Journal of Anesthesiology. 1997;33(6):1185-1191. https://doi.org/10.4097/kjae.1997.33.6.1185
  27. Higgins PT, Green S. Cochrane Handbook for systematic review of intervention [Internet]. England: The Cochrane Collaboration; 2011 [cited 2012 Oct 20]. Available from: http://handbook.cochrane.org/.
  28. Thomas JA, McIntosh JM. Are incentive spirometry, intermittent positive pressure breathing, and deep breathing exercise effective in the prevention of postoperative pulmonary complications after upper abdominal surgery? A systematic overview and meta-analysis. Physical Therapy. 1994;74(1):3-10. https://doi.org/10.1093/ptj/74.1.3
  29. Milgrom LB, Brooks JA, Qi R, Bunnell K, Wuestfeld S, Beckman D. Pain levels experienced with activities after cardiac surgery. American Joournal of Critical Care. 2004;13(2):116-125.
  30. Sethares KA, Chin E, Costa I. Pain intensity, interference and patient pain management strategies the first 12 weeks after coronary artery bypass graft surgery. Applied Nursing Research. 2013;26(4):174-179. http://dx.doi.org/10.1016/j.apnr.2013.07.005

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