Learn to breathe before abdominal surgery

Published on 1^st March 2018

Simple breathing training with a physiotherapist before surgery could prevent postoperative pneumonia, according to a study published in The BMJ.

A trial involving 441 adults found that cases of pneumonia and other serious lung complications, following major abdominal surgery, were halved when patients were taught breathing exercises that they needed to do immediately on waking from the operation.

The researchers said their results “are directly applicable to the tens of millions of patients listed for elective major abdominal surgery worldwide” and that the practice “could be considered for all patients awaiting upper abdominal surgery”.

Upper abdominal surgery involves opening up the abdomen, e.g. to treat bowel, liver or kidney conditions. It is the most common major surgical procedure performed in developed countries, but it carries a risk of serious lung (pulmonary) complications such as pneumonia and lung collapse, which are linked to high mortality and healthcare costs.

In the trial, subjects who were within six weeks of elective upper abdominal surgery were randomly assigned to receive either an information booklet (control) or an additional 30 minute face-to-face physiotherapy education and breathing exercise training session (intervention) by a physiotherapist.

After surgery, patients were assessed every day for 14 days for signs of pulmonary complications. Longer-term measures, such as length of hospital stay, use of intensive care unit services, hospital costs, and all-cause mortality, were also recorded.

After taking account of potentially influential factors, such as patient age and presence of other disorders (comorbidities), the rate of pulmonary complications within 14 days of surgery, including hospital acquired pneumonia, was halved in the intervention group compared with the control group, with an absolute risk reduction of 15 per cent.

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Reference:

1. bmj.com/content/360/bmj.j5916