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Os efeitos da pressao positiva intermitente e do incentivador respiratorio no pos-operatorio de revascularizacao miocardica (The effects of intermittent positive pressure and incentive spirometry in the postoperative of myocardial revascularization) [Portuguese]
Romanini W, Muller AP, Carvalho KA, Olandoski M, Faria-Neto JR, Mendes FL, Sardetto EA, Costa FD, Guarita-Souza LC
Arquivos Brasileiros de Cardiologia 2007 Aug;89(2):105-110
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Pulmonary complications are important causes of morbidity and fatalities among patients subject to cardiac surgery. The respiratory physiotherapy has been aiding in the recovery of these patient ones. OBJECTIVE: To evaluate the physiotherapeutic effect of intermittent positive pressure breathing (IPPB) and incentive spirometry (IS) in patients submitted to myocardial revascularization surgery. METHODS: Forty patients were divided in two groups: one was submitted to IPPB (n = 20) and the other to IS (n = 20). The patients were evaluated at the preoperative period and 24, 48 and 72 hours postoperatively, with the resources being applied in the postoperative period. The following parameters were analyzed: oxygen saturation (SpO2), respiratory frequency (RF), minute volume (MV), current volume (CV), maximum inspiratory pressure (Ip max) and maximum expiratory pressure (Ep max). RESULTS: The groups were considered homogeneous regarding the demographic and clinical variables. In the group submitted to IPPB, an increase in SpO2 was observed 48 (p = 0.007) and 72 h (p = 0.0001) after surgery, when compared to the IS group. As for the RF, MV and CV variables, there were no statistically significant differences between the groups. The group submitted to IS showed a significant increase in the Epmax 24 (p = 0.02) and 48 (p = 0.01) h after surgery. CONCLUSION: Aiming at reversing hypoxemia earlier, IPPB showed to be more efficient when compared to IS; however, IS was more effective in improving respiratory muscle strength.

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