Positive Airway Pressure Versus Breathing Exercises With Load Inspiratory in Patients Undergoing Bariatric Surgery
Condition: Inadequate or Impaired Respiratory Function
MeSH terms: Respiratory Insufficiency
Study type: Interventional

Summary: 
      Obesity, due to excess fat in the thoracoabdominal region, can promote changes in respiratory
      function and lung function, leading to reduction in lung volume and capacity. Such
      dysfunctions are worsen after bariatric surgery to be associated with factors inherent to
      this procedure. The objective of this study was to evaluate and compare the effects of the
      application of bilevel positive airway pressure and exercises with inspiratory pressure with
      linear load in thoracoabdominal mobility, pulmonary function, inspiratory muscle strength,
      respiratory muscle strength and prevalence of pulmonary complications after bariatric
      surgery.
    

Detailed description: 
      This is a clinical trial, randomized, blinded, in which 60 volunteers, after evaluation
      preoperatively, consisting of: cirtometry to measure thoracoabdominal mobility, spirometry
      for measures of lung function, nasal inspiratory pressure to inspiratory muscle strength and
      endurance incremental test for evaluation of respiratory muscle strength, were randomized and
      allocated into three groups, with 20 volunteers each. The interventions were performed in the
      immediate postoperative period and the first day after surgery. The first group, called the
      control group received care by Conventional Respiratory Physiotherapy (CRP), consisting of
      breathing exercises, incentive spirometer and ambulation. The second group, called Positive
      Pressure Group received two-level positive airway pressure for one hour, addition of CRP. The
      third group, called Load Inspiratory Group held exercises with inspiratory pressure with
      linear load, linked also to the CRP. Treatments were applied twice in the immediate
      postoperative period and shortly after returning to the ward and after 4 hours of the initial
      treatment and three times a day on the first day after surgery. On discharge, the second day
      after surgery, the volunteers performed chest x-ray and underwent the same evaluations
      performed preoperatively.
    

Intervention name(s): Bilevel positive airway pressure; PowerBreathe; Conventional Respiratory Physiotherapy (CRP)
Intervention type(s): Device; Device; Procedure
Intervention description(s): The use of positive airway pressure airway seeking in 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; Exercises with inspiratory load has the aim to trainning inspiratory muscle in strength and endurance, thus, could help to prevent postoperative complications.; CRP consisted of diaphragmatic respiratory exercises, deep inhalation exercises, inhalations fragmented two to three times and respiratory exercises associated with shoulder flexion movements and extension of the upper limbs. One series of 10 repetitions was carried out for each exercise. Walking sessions and preventive exercises for deep vein thrombosis were carried out
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: gastroplasty, breathing exercices, positive pressure