Major Abdominal Surgery, Incidence of Pulmonary Complications, ICOUGH Care Program.
Condition: Pulmonary Complications; Major Abdominal Surgery
Study type: Interventional

Summary: 
      This study aims to determine the efficacy of a suite of interventions for reducing
      postoperative pulmonary complications (PPCs) after major abdominal surgery (MAS),
      participants were subjected to the "I COUGH" care program designed to support their health
      condition and reduce complications. The study aimed to investigate a simple and inexpensive
      pulmonary care program that can be easily understood and remembered by patients, their
      families, and medical staff. To achieve this goal, we chose to implement the I COUGH care
      program and determine the effectiveness of a range of interventions to reduce PCs after MAS.

      Two hypotheses identified in the study:

      H0: The ICOUGH care program reduces the incidence of PPCs after MAS. H1: The ICOUGH care
      program after MAS does not affect the incidence of PPCs.
    

Detailed description: 
      Surgery can result in several complications within the lungs, including respiratory
      infections, respiratory failure, pneumothorax, bronchospasm, pleural effusion, atelectasis,
      and aspiration pneumonitis. These postoperative pulmonary complications (PPCs) can make it
      difficult for patients to breathe and recover following surgery and can also increase the
      risk of death and disability.

      In this study, 60 adult patients between the ages of 30 and 60 (mean 39.9; SD±8.82) (M/F:
      13/47) underwent major abdominal surgery requiring general anesthesia and hospitalization,
      such as hernia repair, gall bladder removal, exploratory laparotomy, or other abdominal
      cavity procedures performed by laparoscopy or conventional laparotomy with a 5 cm or less
      incision above or extending above the umbilicus. The participants were randomly assigned to
      either the control group (n=30) or the experimental group using the block randomization
      method.

      The Statistical Package for the Social Sciences (SPSS) version 26 Win 64 was utilized for
      statistical analysis. A Paired samples T-test was conducted to compare pre- and
      post-treatment variables, while an Independent samples T-test was carried out to examine the
      difference between groups. The level of significance was set at p<0.05.

      The current study findings demonstrate that patients who underwent MAS were less prone to PCs
      after being treated with the I COUGH care program following surgery. This program comprised a
      flow-incentive spirometer, oral care, coughing and breathing exercises, patient, and family
      education, getting out of bed, and elevating the head of the bed more than 30 degrees. The
      results of the study revealed that I COUGH was effective in decreasing the incidence of PCs,
      with statistically significant differences found between the experimental and control groups
      (P<0.05).
    

Intervention name(s): I COUGH care program
Intervention type(s): Other
Intervention description(s): I COUGH care program included a flow-incentive spirometer 10 times every 2 hours (10 efforts each set), from awake until discharge, coughing and deep breathing 3-5 times every 2 hour, and oral care at 8:00 am and 8:00 pm. including brushing teeth and rinsing with mouthwash; understanding by education of patient and family; getting out of bed to chair at least once on the day of the operation, walking at least once on the day of the operation, and out of bed to chair and walking in corridor at least three times per day, and raising the head of the bed more than 30 degrees.
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: A total of 62 patients between the ages of 30 and 60 years volunteered for this study, and the mean age of our study was (mean 39.9; SD±8.82). The participants voluntarily participated in the study. The aim and plan were explained to and informed of the study plan and purpose, and consent was obtained from each patient. Participants were randomly divided into two groups. As a result of the Power analysis using the G*Power program, when the effect size d (effect size): 0.901 is taken, it can be determined for Power:0.80 and α:0.05. The minimum number of samples taken was n=30 individuals for each group.
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Pulmonary Complications, Major Abdominal Surgery, I COUGH.