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Chest physiotherapy with positive expiratory pressure breathing after abdominal and thoracic surgery: a systematic review
Department of Intensive Care, Linköping University Hospital, Linköping, Sweden.
Örebro University, School of Health and Medical Sciences. Department of Medical Sciences, Clinical Physiology, Uppsala University Hospital, Uppsala, Sweden; Department of Physiotherapy and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
2010 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 54, no 3, p. 261-267Article in journal (Refereed) Published
Abstract [en]

A variety of chest physiotherapy techniques are used following abdominal and thoracic surgery to prevent or reduce post-operative complications. Breathing techniques with a positive expiratory pressure (PEP) are used to increase airway pressure and improve pulmonary function. No systematic review of the effects of PEP in surgery patients has been performed previously. The purpose of this systematic review was to determine the effect of PEP breathing after an open upper abdominal or thoracic surgery. A literature search of randomised-controlled trials (RCT) was performed in five databases. The trials included were systematically reviewed by two independent observers and critically assessed for methodological quality. We selected six RCT evaluating the PEP technique performed with a mechanical device in spontaneously breathing adult patients after abdominal or thoracic surgery via thoracotomy. The methodological quality score varied between 4 and 6 on the Physiotherapy Evidence Database score. The studies were published between 1979 and 1993. Only one of the included trials showed any positive effects of PEP compared to other breathing techniques. Today, there is scarce scientific evidence that PEP treatment is better than other physiotherapy breathing techniques in patients undergoing abdominal or thoracic surgery. There is a lack of studies investigating the effect of PEP over placebo or no physiotherapy treatment.

Place, publisher, year, edition, pages
2010. Vol. 54, no 3, p. 261-267
National Category
Medical and Health Sciences Physiotherapy
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-12399DOI: 10.1111/j.1399-6576.2009.02143.xISI: 000274313000001PubMedID: 19878100OAI: oai:DiVA.org:oru-12399DiVA, id: diva2:360321
Available from: 2010-11-02 Created: 2010-11-02 Last updated: 2018-02-23Bibliographically approved

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Westerdahl, Elisabeth

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