MASK PHYSIOTHERAPY IN PATIENTS AFTER HEART-SURGERY - A CONTROLLED-STUDY

Objective: Investigate the effects of mask physiotherapy on post-opera tive complications after thoracic surgery. Design: A prospective, cons ecutive, randomized, controlled study. Setting: Department of Thoracic and Heart Surgery at a University Hospital. The treatments were perfo rmed by experienced and specially trained physiotherapists. Patients: 97 low-risk male patients undergoing coronary artery by-pass graft sur gery were evaluated. 66 patients completed the study. Interventions: T he patients were treated with routine chest physiotherapy alone or sup plied with either positive expiratory pressure (PEP), or inspiratory r esistance-positive expiratory pressure (IR-PEP). Measurements and resu lts: Post-operative pulmonary complications were assessed by forced vi tal capacity (FVC), arterial oxygen tension (PaO2), and chest X-ray ex amination, all measured pre-operatively and on the third and sixth pos t-operative day. There was an almost equal decrease and subsequent ris e in spirometric and blood gas values, but patients treated with the P EP mask had a borderly significantly higher increase in PaO2 from day 3 to day 6 compared with patients treated with no mask. There was an a lmost equal frequency of atelectasis in the 3 treatments. The patients filled in a questionaire expressing their opinion about their treatme nt. Most patients liked their treatment and found it helpful but a lit tle less so in the IR-PEP group. Conclusion: We did not find any signi ficant difference between the three groups; however, a tendency to dec reased risk of having post-operative complications was observed in the groups having positive expiratory pressure (PEP) and inspiratory resi stance-positive expiratory pressure (IR-PEP).