PURPOSE: This study systematically review and meta-analyse the effectiveness of inspiratory muscle training (IMT) to reduce postoperative pulmonary complications (PPC) and length of hospital stay (LOS), both in the preoperative and/or postoperative periods of cardiac, pulmonary, and abdominal surgical patients. Sensitive analysis was performed to examine which patients benefit more from IMT according to methodological features (quality of studies and sample size), patient's characteristics (pulmonary risk stratification, age, and body mass index), type of surgery, period of training, and training protocols (training doses and level of supervision). METHODS: The literature search was made in the electronic databases PubMed, EBSCO, Web of Science, PEDro and Scopus. Only randomized controlled trials were included. Data extraction, quality assessment and meta-analysis were performed. RESULTS: We included 17 randomized controlled trials in the systematic review, of which, 12 were included for the PPC meta-analysis and 11 for the LOS meta-analysis. IMT significantly reduced the risk of PPC (risk ratio (RR) 0.50, 95%CI 0.39 to 0.64, I2 = 0.0%), and a decrease in LOS (mean difference -1.41, 95%CI -2.07 to -0.75, I2 = 0.0%). CONCLUSION: IMT is effective to reduce PPC and LOS in patients undergoing surgery.

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