Prevention of post-operative pulmonary complications by preoperative teaching of coughing and deep breathing
Creators: name: Abegglen, JoAnn Coursey
Publisher: name: University of Utah
Year: 2012
Subjects: Surigical Nursing
Breating Exercises

description: A primary goal for the health team, in caring for the post-operative patient is the prevention of pulmonary complications.  The most common of these complications is atelectasis, or alveolar collapse.  Many methods for maintaining good pulmonary toiletry have been researched and discussed in the literature.  However, there is a lack of research and research findings to substantiate a relationship between coughing and deep breathing and the reduction in the incidence of post-operative pulmonary complications.  The purpose of this study is to investigate the effect of coughing and deep breathing on the prevention of post-operative atelectasis in patients having upper abdominal surgery.  Thirty patients admitted to Utah Valley Hospital in Prove, Utah for upper abdominal surgery during the March through June 1972, were used as subjects.  The subjects were divided into an experimental and control group.  Patients in the experimental group were matched to the control group on points of sex, age and surgery.  Each patient in the study had a preoperative chest x-ray and one on the fourth day following surgery.  Like-wise, each patient had a forced expiratory flow rate, one second vital capacity and total vital capacity when taken using the McKessor Vitalor, preoperatively and daily for four days following surgery.  The control group was not taught to cough and deep breath prior to surgery, nor were they encouraged to cough and deep breath following surgery.  The experimental group was taught a specific procedure for coughing and deep breathing before surgery.  Following surgery the experimental group of patients were coughed and deep breathed every two hours for a four day period.  Using the computer, the data was subjected to a one way analysis of variance, a two way analysis of variance, and Multiple Correlation Testing.  The one way analysis of variance analyzed such preoperative information as age, per cent overweight, maximum expiratory flow rate, one second vital capacity, and total vital capacity.  Results showed that there was no significant difference between the control and experimental groups.  The results of the Multiple Correlation Testing showed a progressively stronger relationship in the post-operative period among the above mentioned variables.  Results of the two way analysis of variance showed that those who reduced pulmonary functions before surgery were in significant trouble during each of the four post-operative days.  The experimental group differed from the control group at the .05 level regarding one second vital capacity on the first post-operative day.  The maximum expiratory flow rate became significant on the second post-operative day and was joined by the total vital capacity on the third day following surgery.  Thus, the conclusion can be drawn that teaching a patient to cough and deep breath before surgery and following him with a specific routine after surgery did reduce the incidence of post-operative atelectasis.