Mask physiotherapy in patients after heart surgery: a controlled study

Abstract

Objective: Investigate the effects of mask physiotherapy on post-operative complications after thoracic surgery.

Design: A prospective, consecutive, randomized, controlled study.

Setting: Department of Thoracic and Heart Surgery at a University Hospital. The treatments were performed by experienced and specially trained physiotherapists.

Patients: 97 low-risk male patients undergoing coronary artery by-pass graft surgery were evaluated. 66 patients completed the study.

Interventions: The patients were treated with routine chest physiotherapy alone or supplied with either positive expiratory pressure (PEP), or inspiratory resistance-positive expiratory pressure (IR-PEP).

Measurements and results: Post-operative pulmonary complications were assessed by forced vital capacity (FVC), arterial oxygen tension (PaO2), and chest X-ray examination, all measured pre-operatively and on the third and sixth post-operative day. There was an almost equal decrease and subsequent rise in spirometric and blood gas values, but patients treated with the PEP mask had a borderly significantly higher increase in PaO2 from day 3 to day 6 compared with patients treated with no mask. There was an almost equal frequency of atelectasis in the 3 treatments. The patients filled in a questionaire expressing their opinion about their treatment. Most patients liked their treatment and found it helpful but a little less so in the IR-PEP group.

Conclusion: We did not find any significant difference between the three groups; however, a tendency to decreased risk of having post-operative complications was observed in the groups having positive expiratory pressure (PEP) and inspiratory resistance-positive expiratory pressure (IR-PEP).