Effect of chest physical therapy with early mobilization on post-operative pulmonary complications in upper abdominal surgeries

Sana Bashir; Furqan Ahmed Siddiqi; Mehreen Baig; Eitazaz Ahmed Bashir; Muhammad Ehab Azim; Muhammad Iqbal Tariq

Abstract
Objective: To determine the effect of early postoperative mobilization combined with chest physical therapy in preventing post-op pulmonary complications after upper abdominal surgeries.
Methodology: This randomized control trial was conducted in Fauji Foundation Hospital Rawalpindi, Pakistan from August 2016 to February 2017. Study consisted sample of 30 patients, between the ages of 11-60 years undergoing upper abdominal surgeries who were selected via non-probability purposive sampling technique. They were randomized via coin toss method into interventional group (n=15) receiving early mobilization with breathing exercises and spirometery and control group (n=15) receiving mobilization after 6 hours of surgery. Data was collected for arterial blood gases, pain via numeric pain rating scale and quality of life through SF-36 questionnaire. Mann -Whitney u test was used for between group analyses.
Results: Mean age of patients was 46.83±13.49 years; 3.34% were males and 96.6% females. No significant difference (P>0.05) was observed between groups on heart rate (HR) and oxygen saturation (SPO2) but there was better improvement in interventional group compared to control group. Significant difference (P<0.05) was observed in respiratory rate (RR) between groups after surgery showing more normal rate in interventional group. Significant difference also between groups was observed in PH and partial pressure of oxygen (PO2), whereas no significant difference was seen in partial pressure of carbon dioxide (PCO2), bicarbonate ions (HCO3), arterial saturation of oxygen (SaO2) and hemoglobin prior to discharge. Significant difference (P<0.05) was seen between groups post-surgery in pain levels and Chest X-rays. Similarly, significant difference was seen on auscultation prior to discharge.
Conclusion: Breathing exercises with spirometery and early post-operative mobilization prevents post pulmonary complications and improves post-operative vital status, blood gases, and quality of life and reduces post-operative pain and length of hospital stay in patients of upper abdominal surgeries.

Key words: Arterial Blood Gases (ABGs), Chest Physical Therapy (CPT), Early Mobilization (EM), Post Pulmonary Complications (PPCs), Upper Abdominal Surgeries (UAS)

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