Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine.
Shanghai Jiangong Hospital.
J Physiother. 2015 Jan;61(1):16-20. doi: 10.1016/j.jphys.2014.11.013. Epub 2014 Dec 19.
Does the use of an oscillating positive expiratory pressure (PEP) device reduce postoperative pulmonary complications in thoracic and upper abdominal surgical patients?
A multi-centre, parallel-group, randomised controlled trial with intention-to-treat analysis, blinding of some outcomes, and concealed allocation.
A total of 203 adults after thoracic or upper abdominal surgery with general anaesthesia.
Participants in the experimental group used an oscillating PEP device, thrice daily for 5 postoperative days. Both the experimental and control groups received standard medical postoperative management and early mobilisation.
Fever, days of antibiotic therapy, length of hospital stay, white blood cell count, and possible adverse events were recorded for 28 days or until hospital discharge.
The 99 participants in the experimental group and 104 in the control group were well matched at baseline and there was no loss to follow-up. Fever affected a significantly lower percentage of the experimental group (22%) than the control group (42%), with a RR of 0.56 (95% CI 0.36 to 0.87, NNT 6). Similarly, length of hospital stay was significantly shorter in the experimental group, at 10.7 days (SD 8.1), than in the control group, at 13.3 days (SD 11.1); the mean difference was 2.6 days (95% CI 0.4 to 4.8). The groups did not differ significantly in the need for antibiotic therapy, white blood cell count or total expense of treatment.
In adults undergoing thoracic and upper abdominal surgery, postoperative use of an oscillating PEP device resulted in fewer cases of fever and shorter hospital stay. However, antibiotic therapy and total hospital expenses were not significantly reduced by this intervention.
NCT00816881.
使用振荡性呼气正压（PEP）设备是否能减少胸外科和上腹部外科患者的术后肺部并发症？
一项多中心、平行组、随机对照试验，意向治疗分析，部分结局设盲，分组隐匿。
总共 203 名接受全身麻醉下胸外科或上腹部手术后的成年人。
实验组患者使用振荡性 PEP 设备，每天 3 次，持续 5 天。实验组和对照组均接受标准术后医疗管理和早期活动。
记录发热、抗生素治疗天数、住院天数、白细胞计数和可能的不良事件，持续 28 天或直至出院。
实验组 99 名患者和对照组 104 名患者的基线特征匹配良好，且无失访。实验组发热的患者比例（22%）明显低于对照组（42%），RR 为 0.56（95%CI 0.36 至 0.87，NNH 为 6）。同样，实验组的住院天数（10.7 天，SD 8.1）明显短于对照组（13.3 天，SD 11.1），平均差异为 2.6 天（95%CI 0.4 至 4.8）。两组在抗生素治疗需求、白细胞计数或总治疗费用方面无显著差异。
在接受胸外科和上腹部手术的成年人中，术后使用振荡性 PEP 设备可减少发热病例和缩短住院时间。然而，这种干预并不能显著减少抗生素治疗和总住院费用。
NCT00816881。
