Comparison of two preoperative inspiratory muscle training programs to prevent pulmonary complications in patients undergoing esophagectomy: a randomized controlled pilot study

Edwin J van Adrichem, Renée L Meulenbroek, John T M Plukker, Henk Groen, Ellen van Weert

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Postoperative pulmonary complications (PPCs) are the most commonly reported complications after esophagectomy. The aim of this study was to examine the effect and feasibility of preoperative inspiratory muscle training-high intensity (IMT-HI), and IMT-endurance (IMT-E) on the incidence of PPCs in patients following esophagectomy for esophageal cancer (EC).

METHOD: A single-blind, randomized, clinical pilot study was conducted between 2009 and 2012. Forty-five participants were assigned to either IMT-HI or IMT-E. Effectiveness was assessed by analyzing PPCs, length of hospital stay (LOS), duration of mechanical ventilation, stay on the intensive care unit, and number of reintubations. Maximal inspiratory pressure and lung function changes were recorded pre- and post-training. Feasibility was assessed by IMT-related adverse events, training compliance, and patients' satisfaction.

RESULTS: Thirty-nine patients could be analyzed, 20 patients in the IMT-HI arm and 19 patients in the IMT-E arm. The incidence of PPCs differed significantly between groups and was almost three times lower for the IMT-HI group (4 vs. 11 patients; p = 0.015). Other differences in favor of the IMT-HI group were LOS (13.5 vs. 18 days; p = 0.010) and number of reintubations (0 vs. 4 patients; p = 0.030). Both interventions proved to be equally feasible.

CONCLUSION: Preoperative IMT-HI showed to be a promising, effective, and feasible intervention to reduce PPCs in EC patients undergoing esophagectomy. Further research with a larger sample size is recommended.

Original languageEnglish
Pages (from-to)2353-2360
Number of pages8
JournalAnnals of surgical oncology
Volume21
Issue number7
DOIs
Publication statusPublished - Jul 2014
Externally publishedYes

Keywords

  • esophagectomy
  • exercise therapy
  • feasibility studies
  • neoplasm staging
  • postoperative complications
  • preoperative care
  • prognosis
  • single-blind methods

Cite this

van Adrichem, Edwin J ; Meulenbroek, Renée L ; Plukker, John T M ; Groen, Henk ; van Weert, Ellen. / Comparison of two preoperative inspiratory muscle training programs to prevent pulmonary complications in patients undergoing esophagectomy : a randomized controlled pilot study. In: Annals of surgical oncology. 2014 ; Vol. 21, No. 7. pp. 2353-2360.
@article{3a5cdce9acf24b96a970620fed154507,
title = "Comparison of two preoperative inspiratory muscle training programs to prevent pulmonary complications in patients undergoing esophagectomy: a randomized controlled pilot study",
abstract = "BACKGROUND: Postoperative pulmonary complications (PPCs) are the most commonly reported complications after esophagectomy. The aim of this study was to examine the effect and feasibility of preoperative inspiratory muscle training-high intensity (IMT-HI), and IMT-endurance (IMT-E) on the incidence of PPCs in patients following esophagectomy for esophageal cancer (EC).METHOD: A single-blind, randomized, clinical pilot study was conducted between 2009 and 2012. Forty-five participants were assigned to either IMT-HI or IMT-E. Effectiveness was assessed by analyzing PPCs, length of hospital stay (LOS), duration of mechanical ventilation, stay on the intensive care unit, and number of reintubations. Maximal inspiratory pressure and lung function changes were recorded pre- and post-training. Feasibility was assessed by IMT-related adverse events, training compliance, and patients' satisfaction.RESULTS: Thirty-nine patients could be analyzed, 20 patients in the IMT-HI arm and 19 patients in the IMT-E arm. The incidence of PPCs differed significantly between groups and was almost three times lower for the IMT-HI group (4 vs. 11 patients; p = 0.015). Other differences in favor of the IMT-HI group were LOS (13.5 vs. 18 days; p = 0.010) and number of reintubations (0 vs. 4 patients; p = 0.030). Both interventions proved to be equally feasible.CONCLUSION: Preoperative IMT-HI showed to be a promising, effective, and feasible intervention to reduce PPCs in EC patients undergoing esophagectomy. Further research with a larger sample size is recommended.",
keywords = "esophagectomy, exercise therapy, feasibility studies, neoplasm staging, postoperative complications, preoperative care, prognosis, single-blind methods, esophageal neoplasmen, esophagectomy, oefeningstherapie, postoperatieve complicaties, preoperatieve zorg, ademhalingsfunctietesten, single-blind methoden",
author = "{van Adrichem}, {Edwin J} and Meulenbroek, {Ren{\'e}e L} and Plukker, {John T M} and Henk Groen and {van Weert}, Ellen",
year = "2014",
month = "7",
doi = "10.1245/s10434-014-3612-y",
language = "English",
volume = "21",
pages = "2353--2360",
journal = "Annals of surgical oncology",
issn = "1534-4681",
publisher = "Springer New York",
number = "7",

}

Comparison of two preoperative inspiratory muscle training programs to prevent pulmonary complications in patients undergoing esophagectomy : a randomized controlled pilot study. / van Adrichem, Edwin J; Meulenbroek, Renée L; Plukker, John T M; Groen, Henk; van Weert, Ellen.

In: Annals of surgical oncology, Vol. 21, No. 7, 07.2014, p. 2353-2360.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Comparison of two preoperative inspiratory muscle training programs to prevent pulmonary complications in patients undergoing esophagectomy

T2 - a randomized controlled pilot study

AU - van Adrichem, Edwin J

AU - Meulenbroek, Renée L

AU - Plukker, John T M

AU - Groen, Henk

AU - van Weert, Ellen

PY - 2014/7

Y1 - 2014/7

N2 - BACKGROUND: Postoperative pulmonary complications (PPCs) are the most commonly reported complications after esophagectomy. The aim of this study was to examine the effect and feasibility of preoperative inspiratory muscle training-high intensity (IMT-HI), and IMT-endurance (IMT-E) on the incidence of PPCs in patients following esophagectomy for esophageal cancer (EC).METHOD: A single-blind, randomized, clinical pilot study was conducted between 2009 and 2012. Forty-five participants were assigned to either IMT-HI or IMT-E. Effectiveness was assessed by analyzing PPCs, length of hospital stay (LOS), duration of mechanical ventilation, stay on the intensive care unit, and number of reintubations. Maximal inspiratory pressure and lung function changes were recorded pre- and post-training. Feasibility was assessed by IMT-related adverse events, training compliance, and patients' satisfaction.RESULTS: Thirty-nine patients could be analyzed, 20 patients in the IMT-HI arm and 19 patients in the IMT-E arm. The incidence of PPCs differed significantly between groups and was almost three times lower for the IMT-HI group (4 vs. 11 patients; p = 0.015). Other differences in favor of the IMT-HI group were LOS (13.5 vs. 18 days; p = 0.010) and number of reintubations (0 vs. 4 patients; p = 0.030). Both interventions proved to be equally feasible.CONCLUSION: Preoperative IMT-HI showed to be a promising, effective, and feasible intervention to reduce PPCs in EC patients undergoing esophagectomy. Further research with a larger sample size is recommended.

AB - BACKGROUND: Postoperative pulmonary complications (PPCs) are the most commonly reported complications after esophagectomy. The aim of this study was to examine the effect and feasibility of preoperative inspiratory muscle training-high intensity (IMT-HI), and IMT-endurance (IMT-E) on the incidence of PPCs in patients following esophagectomy for esophageal cancer (EC).METHOD: A single-blind, randomized, clinical pilot study was conducted between 2009 and 2012. Forty-five participants were assigned to either IMT-HI or IMT-E. Effectiveness was assessed by analyzing PPCs, length of hospital stay (LOS), duration of mechanical ventilation, stay on the intensive care unit, and number of reintubations. Maximal inspiratory pressure and lung function changes were recorded pre- and post-training. Feasibility was assessed by IMT-related adverse events, training compliance, and patients' satisfaction.RESULTS: Thirty-nine patients could be analyzed, 20 patients in the IMT-HI arm and 19 patients in the IMT-E arm. The incidence of PPCs differed significantly between groups and was almost three times lower for the IMT-HI group (4 vs. 11 patients; p = 0.015). Other differences in favor of the IMT-HI group were LOS (13.5 vs. 18 days; p = 0.010) and number of reintubations (0 vs. 4 patients; p = 0.030). Both interventions proved to be equally feasible.CONCLUSION: Preoperative IMT-HI showed to be a promising, effective, and feasible intervention to reduce PPCs in EC patients undergoing esophagectomy. Further research with a larger sample size is recommended.

KW - esophagectomy

KW - exercise therapy

KW - feasibility studies

KW - neoplasm staging

KW - postoperative complications

KW - preoperative care

KW - prognosis

KW - single-blind methods

KW - esophageal neoplasmen

KW - esophagectomy

KW - oefeningstherapie

KW - postoperatieve complicaties

KW - preoperatieve zorg

KW - ademhalingsfunctietesten

KW - single-blind methoden

U2 - 10.1245/s10434-014-3612-y

DO - 10.1245/s10434-014-3612-y

M3 - Article

VL - 21

SP - 2353

EP - 2360

JO - Annals of surgical oncology

JF - Annals of surgical oncology

SN - 1534-4681

IS - 7

ER -