Positive Airway Pressure Versus Breathing Exercises With Load Inspiratory in Patients Undergoing Bariatric Surgery

Universidade Metodista de Piracicaba

Status: Completed

Conditions: Inadequate or Impaired Respiratory Function

Treatments: Device: PowerBreathe; Procedure: Conventional Respiratory Physiotherapy (CRP); Device: Bilevel positive airway pressure

Study type: Interventional

Funder types: Other

Identifiers

NCT02682771

UMetodistaPiracicaba

Details and patient eligibility

About

Obesity, due to excess fat in the thoracoabdominal region, can promote changes in respiratory function and lung function, leading to reduction in lung volume and capacity. Such dysfunctions are worsen after bariatric surgery to be associated with factors inherent to this procedure. The objective of this study was to evaluate and compare the effects of the application of bilevel positive airway pressure and exercises with inspiratory pressure with linear load in thoracoabdominal mobility, pulmonary function, inspiratory muscle strength, respiratory muscle strength and prevalence of pulmonary complications after bariatric surgery.

Full description

This is a clinical trial, randomized, blinded, in which 60 volunteers, after evaluation preoperatively, consisting of: cirtometry to measure thoracoabdominal mobility, spirometry for measures of lung function, nasal inspiratory pressure to inspiratory muscle strength and endurance incremental test for evaluation of respiratory muscle strength, were randomized and allocated into three groups, with 20 volunteers each. The interventions were performed in the immediate postoperative period and the first day after surgery. The first group, called the control group received care by Conventional Respiratory Physiotherapy (CRP), consisting of breathing exercises, incentive spirometer and ambulation. The second group, called Positive Pressure Group received two-level positive airway pressure for one hour, addition of CRP. The third group, called Load Inspiratory Group held exercises with inspiratory pressure with linear load, linked also to the CRP. Treatments were applied twice in the immediate postoperative period and shortly after returning to the ward and after 4 hours of the initial treatment and three times a day on the first day after surgery. On discharge, the second day after surgery, the volunteers performed chest x-ray and underwent the same evaluations performed preoperatively.

Enrollment: 60 patients

Sex: Female

Ages: 25 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Submitted to Roux-en-Y type gastric bypass by laparotomy
• Normal preoperative pulmonary function and chest x-ray

Exclusion criteria

• Hemodynamic instability
• Hospital Stay longer than three days
• Presence of postoperative complications
• Smoking
• Respiratory chronic diseases

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Triple Blind

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60 participants in 3 patient groups

Control

Active Comparator group

Description:

Individuals were treated with Conventional Respiratory Physiotherapy (CRP), twice in immediate postoperative day and three times in first postoperative day.

Treatment:

Procedure: Conventional Respiratory Physiotherapy (CRP)

Bilevel positive airway pressure

Experimental group

Description:

Individuals were treated with positive pressure, in the BIPAP mode (bilevel positive airway pressure, with inspiratory pressure:12 cmH20 and expiratory pressure: 8 cmH20) twice in the immediate postoperative day and three times in first postoperative day, in sessions 1 hour each

Treatment:

Device: Bilevel positive airway pressure

Procedure: Conventional Respiratory Physiotherapy (CRP)

Load inspiratory breathing exercises

Experimental group

Description:

Individuals were treat with PowerBreathe, a device for inspiratory muscle, with 40% maximal inspiratory pressure, measured at preoperative, twice in the immediate postoperative day and three times in first postoperative day, in sessions 1 hour each.

Treatment:

Procedure: Conventional Respiratory Physiotherapy (CRP)

Device: PowerBreathe