3 DIFFERENT MASK PHYSIOTHERAPY REGIMENS FOR PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS AFTER HEART AND PULMONARY SURGERY

Objective. An investigation into the incidence of post-operative compl ications after thoracic surgery with 3 different Physiotherapy masks. Design: A prospective, consecutive, randomized comparison. Setting: De partment of Thoracic and Heart Surgery at a University Hospital. The t reatments were performed by experienced and specially trained physioth erapists. Patients: 160 patients were evaluated. 60 patients undergoin g heart surgery, 59 patients having pulmonary resection, and 41 patien ts with exploratory thoracotomy. Interventions: In each operative cate gory the patients were treated with one of three face mask systems use d in addition to routine chest physiotherapy. These were either contin uous positive airway pressure (CPAP), positive expiratory pressure (PE P), or inspiratory resistance - positive expiratory pressure (IR-PEP). Measurements and results. Post-operative pulmonary complications were assessed by forced vital capacity (FVC), arterial oxygen tension (PaO 2), and chest X-ray examination, all measured pre-operatively and on t he fourth and ninth post-operative day. The patients filled in a quest ionnaire expressing their opinion about their mask treatment. There wa s an equal decrease in FVC, FVC%, and PaO2, and equal frequency of ate lectasis in the 3 mask treatments. More patients with the PEP mask fav oured their system than did those with the other 2 systems. Conclusion : There was no statistically significant difference between the treatm ents: continuous positive airway pressure (CPAP), positive expiratory pressure (PEP), and inspiratory resistance - positive expiratory press ure (IR-PEP) on post-operative complications. Any of the three treatme nts may be used as supplement to standard chest physiotherapy.