Preoperative physiotherapy in prevention of pulmonary complications in pediatric cardiac surgery

Abstract

Objective: To evaluate the occurrence and risk of pulmonary complications in children who underwent preand postoperative physiotherapeutic intervention in cardiac surgeries, as well as to compare these patients to those who underwent only postoperative physiotherapeutic intervention. Methods: A randomized clinical trial was performed with 135 patients from 6 years of age and younger with congenital heart disease who had undergone cardiac surgery. Patients were randomly assigned to the intervention group (G1) in which they underwent pre- and postoperative physiotherapy, or to the control group (G2) in which they underwent only postoperative physiotherapy. Mann-Whitney and the Chisquare tests were used to compare the variables between the groups. The magnitude of the absolute risk was calculated by the number of patients needing treatment. Statistical significance was set at 5% (p<0.05). Results: 17 patients (25%) in G1, and 29 patients (43.3%) in G2 presented pulmonary complications (p= 0.025). Pneumonia was the most frequent complication, and among the 17 patients in G1, seven (10.3%) developed pneumonia, six (8.8%) developed atelectasis, and four (5.9%) presented complications due to both complications. In G2, 13 patients (19.4%) developed pneumonia, eight (11.9%) developed atelectasis, and eight (11.9%) developed pneumonia associated with atelectasis. Absolute risk reduction for the primary outcome was of 18.3% and the number of necessary treatments was 5.5. Conclusion: Preoperative respiratory physiotherapy significantly reduced the risk of pulmonary complications in postoperative pediatric cardiac surgery. Descriptors: Physical therapy modalities. Cardiac surgical procedures. Child.