engleski

Preoperative respiratory rehabilitation

Respiratory physical therapy has its role in prevention and treatment of postoperative pulmonary complications. Postoperative complications are usually presented with restrictive form, reduced inspiratory capacity, vital capacity and functional residual capacity. Patients ability to clear his airway of sputum is reduced due to anesthesia and reduced cough strength. The goal of preoperative care is to reduce the risk of noninfectious and infectious pulmonary complications. Most common complications are atelectasis, pneumonia and reduced mobility. Implementation of preoperative physiotherapy is not a routine but has been found very useful for the patients. For example, in elderly patients and the ones with COPD there is decrease in postoperative pulmonary morbidity. Patients with COPD have a tendency of increased bronchial secretion and may require pulmonary hygiene before the operation. Preoperative care can vary just from practical education about postoperative airway clearence techniques to learning about detailed intensive pulmonary hygiene. Wound pain and pain from drainage location can be severe for a few days and can lead to abnormal breathing patterns. Decreased functional residual capacity causes atelectasis. Patients cannot cough normally and because of it they have the tendency of accumulate secretion which leads to an infection and arterial hypoxemia. Good postoperative control of pain can improve efficiency of physical therapy. TENS (transcutaneous electrical nerve stimulation) can be used in patients with persistent shoulder pain after thoracic incision. Antalgic, supportive positions and interventions are used during respiratory therapy and therapeutic exercises and also reduce pain. The goals of physiotherapy are: education of the patient (preventive consultation and coaching), increasing lung volume, sputum elimination, maintaining range of motion of the upper extremities and early mobilization/verticalization.

physical therapy ; respiration ; preoperative

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