Effect of preoperative threshold inspiratory muscle training on postoperative hospital stay in adults undergoing cardiac surgery: a systematic review

Adele Cook, Laura Smith, Callum Anderson, Nicole Ewing, Ashley Gammack , Mark Pecover, Nicole Sime, Helen F. Galley* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Systematic reviews have reported benefits of preoperative inspiratory muscle training in adults undergoing cardiac surgery, however there have been inconsistencies with the devices used. Threshold devices generate a constant inspiratory load independent of respiratory rate.
Objective: To assess the effect of preoperative inspiratory muscle training using threshold devices in adults undergoing cardiac surgery.
Methods: A literature search was conducted across five electronic databases. Seven randomized controlled trials met the inclusion criteria and were critically appraised. The primary outcome was length of hospital stay. Secondary outcomes included postoperative pulmonary complications, quality of life and mortality.
Results: Seven eligible randomized controlled trials were identified with a total of 642 participants. One study was a post hoc analysis of one of the included studies. Three out of five studies reported a decrease in length of postoperative hospital stay (p<0.05). A significant reduction in postoperative pulmonary complications was reported by three studies (p<0.05).
There were concerns with bias across all papers. Conclusions: Preoperative threshold inspiratory muscle training has potential to reduce postoperative length of hospital stay and pulmonary complications after cardiac surgery. The
evidence on quality of life and mortality is inconclusive. The overall evidence for these conclusions may be influenced by bias.
Original languageEnglish
JournalPhysiotherapy: Theory and Practice
DOIs
Publication statusAccepted/In press - 25 Nov 2021

Keywords

  • inspiratory muscle training
  • threshold device
  • cardiac surgery
  • hospital stay
  • pulmonary complications

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