Comparison among positive pressure, standard physioterapy and incentive spirometry after cardiac surgery: literature review

Abstract

Introduction: Postoperative pulmonary complications in patients undergoing cardiac surgeries are usually a clinical challenge, which can be prevented and treated with specific physical therapy techniques.However, it is not known which technique is the most effective. Objective: Literature review with theobjective of assessing the effectiveness of positive pressure (CPAP, IPPB, NIV-2P) compared to standardphysioterapy therapy and incentive spirometry on improving pulmonary function in postoperative cardiacsurgery patients. Methods: English and Portuguese studies were used as references, searching forspecific descriptors on the following data sources: BIREME, SciELO Brazil, LILACS, PUBMED, from 1985to 2010. Only randomized clinical trials were included. Results: Ten randomized control trials wereincluded in this review. About the most effective technique, two studies showed that CPAP and NIV-2Pwere more effective than standard physioterapy and incentive spirometry. In other two studies, NIV-2Pwere more effective than nasal oxygen catheter and standard physioterapy. Conclusion: There is noevidence in the literature about the most effective physiotherapy technique. Also, it is not known if theassociation of positive pressure, standard physioterapy and incentive spirometry can be more effective.It is important to emphasize that no selected study compared the three modalities of positive pressure.