Mask physiotherapy in patients after heart surgery: a controlled study.

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).