Effectiveness of preoperative and perioperative pulmonarrehabilitation nursing program for the management of patients undergoing thoracic surgery: A systematic review and meta-analysis

Abstract

Background & Objective: Several studies have investigated the effectiveness of preoperative or perioperative pulmonary rehabilitation in thoracic surgery patients, but the results are inconsistent and inconclusive. This study attempts to summarize the existing data on the effect of the preoperative and perioperative pulmonary rehabilitation nursing program for the management of patients undergoing thoracic surgery. Methods: Systematic search was done in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar, and ScienceDirect for papers published until December 2022 and reporting data of postoperative complications and pulmonary health status in patients undergoing thoracic surgery and receiving preoperative or perioperative pulmonary rehabilitation nursing intervention or standard care. Meta-analysis was done by random-effects model and pooled standardised mean differences (SMD) or odds ratios (OR) along with 95% confidence intervals (CIs) were reported. Results: Eighteen studies were included and analysed. Pooled SMD was 0.44 (95%CI:-0.21 to 1.08) for forced expiratory volume (FEV-1),-0.34 (95%CI:-0.94 to 0.26) for peak expiratory flow (PEF), 0.61 (95%CI:-0.60 to 1.81) for forced vital capacity (FVC), 0.42 (95%CI:-0.13 to 0.98) for diffusing capacity of carbon monoxide (DLCO). Pooled SMD for length of hospital stay was-0.64 (95%CI:-1.09 to-0.19). Pooled OR was 0.87 [95%CI: 0.32 to 2.37] for all-cause mortality, 0.35 [95%CI: 0.25 to 0.50] for postoperative pulmonary complications, 0.98 [95%CI: 0.45 to 2.12] for respiratory failure, 0.52 [95%CI: 0.38 to 0.78] for pneumonia and 0.50 [95%CI: 0.33 to 0.76] for atelectasis. Conclusion: Perioperative pulmonary rehabilitation nursing program is effective in reducing the postoperative lung complications and shortening the length of hospital stay in patients undergoing thoracic surgery.