Do Directed Cough Maneuvers Improve Cough Effectiveness in the Early Period After Open Heart Surgery? Effect of Thoracic Support and Maximal Inspiration on Cough Peak Expiratory Flow, Cough Expiratory Volume, and Thoracic Pain

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dc.contributor.authorFiore Junior, Julio Flavio [UNIFESP]
dc.contributor.authorChiavegato, Luciana Dias [UNIFESP]
dc.contributor.authorDenehy, Linda
dc.contributor.authorPaisani, Denise de Moraes [UNIFESP]
dc.contributor.authorFaresin, Sonia Maria [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Melbourne
dc.date.accessioned2018-06-18T11:35:35Z
dc.date.available2018-06-18T11:35:35Z
dc.date.issued2008-08-01
dc.description.abstractBACKGROUND: Directed cough maneuvers are often included in physiotherapy management aimed at preventing postoperative pulmonary complications after open heart surgery, but there is little scientific evidence of the effectiveness of directed cough maneuvers. METHODS: We conducted a randomized intra-subject crossover trial to evaluate the effect of thoracic support (patient holds his or her hands over the incision) and maximal inspiration on cough peak expiratory flow (CPEF), cough expiratory volume (CEV), and incision pain during cough in the early period after open heart surgery. Cough evaluation was undertaken on the first and second morning after surgery. On both measurement days the subject did a baseline cough (baseline cough 1) then, in a random sequence, performed 3 cough conditions: an additional baseline cough (baseline cough 2), supported cough, and supported cough preceded by maximal inspiration. In these test conditions a P < .008 was deemed to indicate a statistically significant difference. RESULTS: Twenty-one subjects participated. Thoracic support alone did not significantly affect CPEF or CEV (Bonferroni adjusted P > .008). With a maximal inspiration and thoracic support, CPEF and CPEV were significantly higher than in all other cough conditions (Bonferroni adjusted P < .008). Pain during cough was not influenced by the different cough conditions (P > .05). There was no significant difference in the cough variables or pain during the different cough conditions on the first day versus the second measurement day. CONCLUSIONS: Maximal inspiration increased CPEF and CEV, but the method of thoracic support we used did not reduce pain during cough or influence the cough values we measured.en
dc.description.affiliationUniv Fed Sao Paulo, Resp Dept, Sao Paulo, Brazil
dc.description.affiliationUniv Melbourne, Sch Physiotherapy, Melbourne, Vic, Australia
dc.description.affiliationUnifespUniv Fed Sao Paulo, Resp Dept, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipMinistry of Education, Brazil.
dc.format.extent1027-1034
dc.identifierhttp://rc.rcjournal.com/content/53/8/1027
dc.identifier.citationRespiratory Care. Irving: Daedalus Enterprises Inc, v. 53, n. 8, p. 1027-1034, 2008.
dc.identifier.issn0020-1324
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/45209
dc.identifier.wosWOS:000258332300006
dc.language.isoeng
dc.publisherDaedalus Enterprises Inc
dc.relation.ispartofRespiratory Care
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectcoughen
dc.subjectrespiratory physiotherapyen
dc.subjectcardiac surgeryen
dc.subjectrespiratory complicationsen
dc.subjectpostoperative careen
dc.subjectpostoperative painen
dc.titleDo Directed Cough Maneuvers Improve Cough Effectiveness in the Early Period After Open Heart Surgery? Effect of Thoracic Support and Maximal Inspiration on Cough Peak Expiratory Flow, Cough Expiratory Volume, and Thoracic Painen
dc.typeinfo:eu-repo/semantics/article
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