Surgery, Undernutrition
Conditions
Keywords
undernutrition, abdominal surgery, respiratory muscles, muscles strength, pulmonary complication, perioperative care
Brief summary
Malnutrition affects 50% of hospitalized patients around the world and causes changes in respiratory muscles predisposing the development of pulmonary complications probable, because of the ineffectiveness of cough. How the training of respiratory muscles can improve the effectiveness of cough, malnourished patients could benefit from this train however, the training of the muscles in malnourished patients has not been tested for safety or efficiency. So, the aim of this study is to assess the safety and efficiency of respiratory muscle training to improve the potency of cough in malnourished patients.
Interventions
Patient performs training for 30 minutes per day, during 7 consecutive days, using a Threshold with Positive Expiratory Pressure with a load of 30% of maximal expiratory pressure assessed by digital peak respiratory pressure monitor
OTHERInspiratory muscle training
Patient performs training for 30 minutes per day, during 7 consecutive days, using a Threshold for Inspiratory Muscle Training with a load of 30% of maximal inspiratory pressure assessed by digital peak respiratory pressure monitor
OTHERSham group
Patient performs training for 30 minutes per day, during 7 consecutive days, using a Threshold without load
Sponsors
University of Sao Paulo General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* hospitalized malnourished patients (BMI ≤ 20 Kg/m2, loss of body weight ≥ 10% unintentional, or serum albumin \<3.5 g/dL) * candidate to elective abdominal surgery * ability to perform all evaluations and training
Exclusion criteria
* previous respiratory disease * necessity of over than 48h of mechanical ventilation * reoperation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Expiratory peak flow in spirometry | on the 8th day of protocol (after 7 dyas of training) | Assessed as expiratory peak flow in spirometry |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximum respiratory pressures | on the 8th day of protocol (after 7 days of training) | Assessed by digital peak respiratory pressure monitor as maximum inspiratory pressure and maximum expiratory pressure |
| Postoperative pulmonary complication | participants will be followed for the duration of hospital stay after surgery, an expected average of 10 days | The following pulmonary complications were considered: atelectasis with clinical consequences, hypoxemia with oxygen saturation \<85%, and need for supplemental oxygen, pneumonia and acute respiratory failure. The diagnosis of complication was performed by a physician who was blinded to the intervention group. |
Countries
Brazil
Outcome results
None listed