+AA
Fr
McMasterLogo_New-2017-300x165
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Inspiratory muscle training before cardiothoracic or upper abdominal surgery reduces lung complications from surgery

Mans CM, Reeve JC, Elkins MR. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis. Clin Rehabil. 2015;29:426-8.

Review question

In people who have cardiothoracic (relating to the heart or chest) or upper abdominal surgery, does inspiratory muscle training before surgery reduce lung complications from surgery and length of hospital stay?

Background

People who have cardiothoracic or upper abdominal surgery can develop complications such as pneumonia or collapsed lungs after surgery. These complications may lead to further harm and/or longer hospital stays.

Weakness of respiratory muscles may contribute to lung complications after surgery. Therefore, strengthening of inspiratory muscles—the muscles used to breathe in—through training before surgery may help reduce the risk of lung complications after surgery.

How the review was done

The researchers did a systematic review based on studies available up to December 2013.

They found 8 randomized controlled trials with 295 people (average age 35 to 71 years, 53% were men).

The key features of the studies were:

  • people had heart, chest, or upper abdominal surgery;
  • all studies used a threshold-loading device for training;
  • training ranged from 1 to 3 sessions per day for 6 or 7 days per week for at least 2 weeks; and
  • training was compared with usual care, no training, or breathing through a tube with little or no resistance.

What the researchers found

The trials had quality scores ranging from of 4/10 to 7/10.

Compared with usual care, no training, or breathing through a tube with little or no resistance, inspiratory muscle training

  • reduced lung complications after surgery; but
  • did not affect length of hospital stay or risk of death.

Conclusion

In people who have cardiothoracic or upper abdominal surgery, inspiratory muscle training before surgery reduces lung complications from surgery but does not reduce length of hospital stay.

Inspiratory muscle training before cardiothoracic or upper-abdominal surgery

Outcomes after surgery

Number of trials (and people)

Rate of events with training

Rate of events with no training

Effects of training

Lung complications

7 trials (249 people)

8.1%

17%

About 9 fewer people out of 100 had lung complications

Length of stay in hospital

4 trials (115 people)

Not applicable

Not applicable

No difference in the length of hospital stay

Death

2 trials (50 people)

16%

4%

No difference in deaths*

*Although the rates for the 2 groups look different, the differences were not statistically significant—this means that the differences could simply be due to chance rather than due to the different treatments.




Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Dementia in long-term care

    Canadian Institute for Health Information
    Older adults with dementia may need to move into long-term care homes if they can no longer stay at home. These people have higher risk of getting physically restrained or given antipsychotic medication. Changes to policy and education have made these things happen less often.
  • Treating pressure ulcers: New evidence, continued uncertainty

    Evidently Cochrane
    Gauze dressings should not be used to treat pressure ulcers (bed sores). Other options include alginate dressings, hydrogel dressings, and negative pressure wound therapy. More evidence is needed about which options are best to improve pain and reduce complications. Research should measure outcomes that matter to patients and carers as well as health professionals.
  • Patient education: Delirium (Beyond the Basics)

    UpToDate - patient information
    Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use