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Feasibility of preoperative inspiratory muscle training in patients undergoing coronary artery bypass surgery with a high risk of postoperative pulmonary complications: a randomized controlled pilot study [with consumer summary]
Hulzebos EH, van Meeteren NL, van den Buijs BJ, de Bie RA, Brutel de la Riviere A, Helders PJ
Clinical Rehabilitation 2006 Nov;20(11):949-959
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine in a pilot study the feasibility and effects of preoperative inspiratory muscle training in patients at high risk of postoperative pulmonary complications who were scheduled for coronary artery bypass graft surgery. DESIGN: Single-blind, randomized controlled pilot study. SETTING: University Medical Centre Utrecht, the Netherlands. SUBJECTS: Twenty-six patients at high risk of postoperative pulmonary complications were selected. INTERVENTION: The intervention group (N = 14) received 2 to 4 weeks of preoperative inspiratory muscle training on top of the usual care received by the patients in the control group. MAIN MEASURES: Primary outcome variables of feasibility were the occurrence of adverse events, and patient satisfaction and motivation. Secondary outcome variables were postoperative pulmonary complications and length of hospital stay. RESULTS: The feasibility of inspiratory muscle training was good and no adverse events were observed. Treatment satisfaction and motivation, scored on 10-point scales, were 7.9 (+/- 0.7) and 8.2 (+/- 1.0), respectively. Postoperative atelectasis occurred in significantly fewer patients in the intervention group than in the control group (kappa2(DF1) = 3.85; p = 0.05): Length of hospital stay was 7.93 (+/- 1.94) days in the intervention group and 9.92 (+/- 5.78) days in the control group (p = 0.24). CONCLUSION: Inspiratory muscle training for 2 to 4 weeks before coronary artery bypass graft surgery was well tolerated by patients at risk of postoperative pulmonary complications and prevented the occurrence of atelectasis in these patients. A larger randomized clinical trial is warranted.

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