A single 30-minute session with a physical therapist yielded significant benefit. As many as 50% of patients who undergo upper abdominal surgery experience postoperative pulmonary complications (PPCs). In this multicenter randomized trial, researchers determined the effectiveness of a single preoperative physical therapy session in lowering risk for PPCs after upper abdominal surgery. A total of 441 adults who were scheduled for elective upper abdominal surgery within 6 weeks were randomized to one of two groups. Patients in the control group received an information booklet that contained information about how to prevent PPCs with early ambulation and breathing exercises, including specific instructions. Patients in the intervention group received the information booklet and a 30-minute education and breathing-exercise training session with a physical therapist. Fewer patients in the intervention group than in the control group experienced PPCs within 14 postoperative days (12% vs. 27%; number needed to treat [NNT], 7) or developed hospital-acquired pneumonia (8% vs. 20%; NNT, 8). No differences were noted in secondary outcomes (e.g., hospital length of stay, mobility, mortality). |
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In this trial, brief preoperative education and breathing-exercise training lowered risks for PPCs and hospital-acquired pneumonia in patients who underwent upper abdominal surgery. The authors recommend this training for all patients who are scheduled for upper abdominal surgery. However, access to physical therapists sometimes is limited, and whether non–physical therapists (e.g., nurses) can deliver such training effectively is unclear.