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Preoperative Inspiratory Muscle Training and Postoperative Complications
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To the Editor: Dr Hulzebos and colleagues1 designed a single-blind, randomized clinical trial to study the prophylactic efficacy of preoperative physical therapy, including IMT, on the incidence of postoperative pulmonary complications (PPCs) in patients at high risk for these complications who underwent CABG surgery. We have 3 concerns about the patients in the study who had advanced cardiac disease.
First, the intervention group trained daily, 7 times a week, for at least 2 weeks before the actual date of surgery, and each session consisted of 20 minutes of IMT. Although 65.6% of patients were New York Heart Association (NYHA) class III or IV, no participants dropped out. It is surprising that patients with marked limitation of activity, or who should be at complete rest or confined to bed or chair, could tolerate this type of training. Similarly, all participants in the IMT group returned the questionnaire, with scores of 8.1 . . . [Full Text of this Article]
Hisato Takagi, MD, PhD
kfgth973@ybb.ne.jp
Norikazu Kawai, MD;
Takuya Umemoto, MD, PhD
Department of Cardiovascular Surgery
Shizuoka Medical Center
Shizuoka, Japan
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