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Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study
BACKGROUND: Physiotherapy is a major cornerstone of enhanced rehabilitation after surgery (ERAS) and reduces the development of atelectasis after thoracic surgery. By initiating physiotherapy in the post-anaesthesia care unit (PACU), the aim was to evaluate whether the ultra-early initiation of reha...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127337/ https://www.ncbi.nlm.nih.gov/pubmed/35607804 http://dx.doi.org/10.1093/bjsopen/zrac063 |
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author | Pastene, Bruno Labarriere, Ambroise Lopez, Alexandre Charvet, Aude Culver, Aurélien Fiocchi, David Cluzel, Armand Brioude, Geoffrey Einav, Sharon Tankel, James Hamidou, Zeinab D’Journo, Xavier Benoit Thomas, Pascal Leone, Marc Zieleskiewicz, Laurent |
author_facet | Pastene, Bruno Labarriere, Ambroise Lopez, Alexandre Charvet, Aude Culver, Aurélien Fiocchi, David Cluzel, Armand Brioude, Geoffrey Einav, Sharon Tankel, James Hamidou, Zeinab D’Journo, Xavier Benoit Thomas, Pascal Leone, Marc Zieleskiewicz, Laurent |
author_sort | Pastene, Bruno |
collection | PubMed |
description | BACKGROUND: Physiotherapy is a major cornerstone of enhanced rehabilitation after surgery (ERAS) and reduces the development of atelectasis after thoracic surgery. By initiating physiotherapy in the post-anaesthesia care unit (PACU), the aim was to evaluate whether the ultra-early initiation of rehabilitation (in the first hour following tracheal extubation) would improve the outcomes of patients undergoing elective thoracic surgery. METHODS: A case–control study with a before-and-after design was conducted. From a historical control group, patients were paired at a 3:1 ratio with an intervention group. This group consisted of patients treated with the ultra-early rehabilitation programme after elective thoracic surgery (clear fluids, physiotherapy, and ambulation). The primary outcome was the incidence of postoperative atelectasis and/or pneumonia during the hospital stay. RESULTS: After pairing, 675 patients were allocated to the historical control group and 225 patients to the intervention group. A significant decrease in the incidence of postoperative atelectasis and/or pneumonia was found in the latter (11.4 versus 6.7 per cent respectively; P = 0.042) and remained significant on multivariate analysis (OR 0.53, 95 per cent c.i. 0.26 to 0.98; P = 0.045). A subgroup analysis of the intervention group showed that early ambulation during the PACU stay was associated with a further significant decrease in the incidence of postoperative atelectasis and/or pneumonia (2.2 versus 9.5 per cent; P = 0.012). CONCLUSIONS: Ultra-early rehabilitation in the PACU was associated with a decrease in the incidence of postoperative atelectasis and/or pneumonia after major elective thoracic surgery. |
format | Online Article Text |
id | pubmed-9127337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91273372022-05-24 Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study Pastene, Bruno Labarriere, Ambroise Lopez, Alexandre Charvet, Aude Culver, Aurélien Fiocchi, David Cluzel, Armand Brioude, Geoffrey Einav, Sharon Tankel, James Hamidou, Zeinab D’Journo, Xavier Benoit Thomas, Pascal Leone, Marc Zieleskiewicz, Laurent BJS Open Original Article BACKGROUND: Physiotherapy is a major cornerstone of enhanced rehabilitation after surgery (ERAS) and reduces the development of atelectasis after thoracic surgery. By initiating physiotherapy in the post-anaesthesia care unit (PACU), the aim was to evaluate whether the ultra-early initiation of rehabilitation (in the first hour following tracheal extubation) would improve the outcomes of patients undergoing elective thoracic surgery. METHODS: A case–control study with a before-and-after design was conducted. From a historical control group, patients were paired at a 3:1 ratio with an intervention group. This group consisted of patients treated with the ultra-early rehabilitation programme after elective thoracic surgery (clear fluids, physiotherapy, and ambulation). The primary outcome was the incidence of postoperative atelectasis and/or pneumonia during the hospital stay. RESULTS: After pairing, 675 patients were allocated to the historical control group and 225 patients to the intervention group. A significant decrease in the incidence of postoperative atelectasis and/or pneumonia was found in the latter (11.4 versus 6.7 per cent respectively; P = 0.042) and remained significant on multivariate analysis (OR 0.53, 95 per cent c.i. 0.26 to 0.98; P = 0.045). A subgroup analysis of the intervention group showed that early ambulation during the PACU stay was associated with a further significant decrease in the incidence of postoperative atelectasis and/or pneumonia (2.2 versus 9.5 per cent; P = 0.012). CONCLUSIONS: Ultra-early rehabilitation in the PACU was associated with a decrease in the incidence of postoperative atelectasis and/or pneumonia after major elective thoracic surgery. Oxford University Press 2022-05-24 /pmc/articles/PMC9127337/ /pubmed/35607804 http://dx.doi.org/10.1093/bjsopen/zrac063 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Pastene, Bruno Labarriere, Ambroise Lopez, Alexandre Charvet, Aude Culver, Aurélien Fiocchi, David Cluzel, Armand Brioude, Geoffrey Einav, Sharon Tankel, James Hamidou, Zeinab D’Journo, Xavier Benoit Thomas, Pascal Leone, Marc Zieleskiewicz, Laurent Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title | Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title_full | Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title_fullStr | Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title_full_unstemmed | Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title_short | Ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
title_sort | ultra-early initiation of postoperative rehabilitation in the post-anaesthesia care unit after major thoracic surgery: case–control study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127337/ https://www.ncbi.nlm.nih.gov/pubmed/35607804 http://dx.doi.org/10.1093/bjsopen/zrac063 |
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