Influence of Different Physical Therapy Resources Application After Reduction Stomach Surgery
Condition: Pulmonary Atelectasis; Respiratory Tract Diseases; Pathological Conditions, Signs and Symptoms
MeSH terms: Pulmonary Atelectasis; Respiratory Tract Diseases
Study type: Interventional

Summary: 
      The aim of this study will be to investigate the effects of using physical therapy resources
      in the postoperative morbidly obese individuals undergoing gastroplasty.

      It is believed that the application of these various features of physiotherapy after
      abdominal surgery may contribute differently in restoring lung function and prevention of
      pulmonary complications and can thus identify the resources that can contribute more
      effectively in post-operative bariatric surgery.
    

Detailed description: 
      The aim of this study will be to investigate the effects of using physical therapy resources
      in the postoperative morbidly obese individuals undergoing Roux-en-Y gastric by-pass with
      regard to: lung volumes and capacities, prevalence of atelectasis, thoracoabdominal mobility
      and evaluation of peak flow of cough, evaluated pre and post operative.

      Individuals with BMI between 40 and 55 Kg/m², aged between 25 and 55 years, underwent the
      surgical procedure Roux-en-Y type gastric by-pass by laparotomy and normal preoperative
      pulmonary function will be included.

      The volunteers will be divided into seven different groups, according to the treatment
      received during hospitalization after surgery:

      G control: subjects treated with conventional physiotherapy according to the routine service
      of physiotherapy of the hospital; G Voldyne: subjects treated with incentive spirometry,
      Voldyne Model 5000® (Sherwood Medical, USA); G CPAP: subjects treated with "continuous
      positive airway pressure"; G EPAP: subjects treated with "expiratory positive airway
      pressure"; G IPPB: subjects treated with "intermittent positive pressure breathing"; G BIPAP:
      subjects treated with "bi-level positive airway pressure"; G BS: subjects treated with
      "breath stacking" (siliconized mask connected to a unidirectional valve allowing only
      inspiration).

      The application of resources will be held twice a day in the immediate and in the first
      postoperative sessions in 6 sets of 15 reps or 30 continuous minutes, with an interval of 4
      hours between sessions. The researcher will remain alongside the volunteers, following them
      and monitoring vital signs and respiratory comfort.
    

Intervention name(s): Continuous positive airway pressure; Incentive spirometry; Breath Stacking; Expiratory Positive Airway Pressure; Intermittent positive pressure breathing; Bi-level positive airway pressure
Intervention type(s): Procedure; Procedure; Procedure; Procedure; Procedure; Procedure
Intervention description(s): The use of positive pressure airway seeking the prevention or treatment of hypoxic respiratory failure, improved arterial oxygenation, restoration or maintenance of lung volume reduction and atelectasis, decrease the work of breathing, decreased dyspnea index and increased residual volume.; The volume of incentive spirometry (Voldyne ®) is able to provide increased transpulmonary pressure gradient, which can prevent or reverse atelectasis.; The method allowed to obtain a maximum lung expansion with minimal patient compliance.; The use of positive pressure airway seeking the prevention or treatment of hypoxic respiratory failure, improved arterial oxygenation, restoration or maintenance of lung volume reduction and atelectasis, decrease the work of breathing, decreased dyspnea index and increased residual volume.; The use of positive pressure airway seeking the prevention or treatment of hypoxic respiratory failure, improved arterial oxygenation, restoration or maintenance of lung volume reduction and atelectasis, decrease the work of breathing, decreased dyspnea index and increased residual volume.; The use of positive pressure airway seeking the prevention or treatment of hypoxic respiratory failure, improved arterial oxygenation, restoration or maintenance of lung volume reduction and atelectasis, decrease the work of breathing, decreased dyspnea index and increased residual volume.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Morbid obesity; Bariatric surgery; Pulmonary atelectasis; Spirometry; Continuos Positive Airway Pressure; Physical therapy speciality