After any surgery, there is a chance of complications. After lung surgery to remove tumours, there is a particularly high chance of a person developing an infection or needing help breathing, called post operative pulmonary complications. Currently, the risk of these complications is reduced through the completion of light physical and deep breathing exercises and walking around as soon as possible after surgery. Another possible way of helping these patients is to use a small device called an Incentive Spirometer to encourage and measure deep breathing. This study wants to compare how often postoperative pulmonary complications happen after major lung surgery between a group completing the exercises alone and a group using the Incentive spirometer in addition to the exercises. It is hoped that the combined therapy will reduce the amount of time patient must stay in hospital, have fewer complication events and have fewer patients re-admitted back into the hospital after they go home, so that patients overall have better outcomes.
This study is a prospective blinded randomized control trial (RCT) where two arms will be assembled. Consenting eligible patients will be randomized to either the physiotherapy + incentive spirometry (PT+IS-intervention) arm or physiotherapy only (PT-control arm). Patients will be randomized with an equal (1:1) chance of being allocated to either the PT (control) arm or PT+IS (intervention) arm. Both the treating surgeon and data interpreter will be blinded to the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
389
Standard of care exercise training and supervision
St. Joseph's Healthcare Hamilton
Hamilton, Ontario, Canada
Rate of post operative pulmonary complications within 30 days of surgery
Postoperative pulmonary complications (PPCs) are defined as: * Pneumonia requiring treatment with antibiotics * Atelectasis requiring pulmonary toilet by bronchoscopy * Respiratory failure requiring treatment via mechanical ventilation (invasive or non-invasive) * Requirement for home oxygen after surgery, when this was not the case prior to surgery
Time frame: 30 days after surgery
Duration of oxygen treatment in hospital
Use of oxygen therapy required while in hospital
Time frame: 30 days post-surgery
Length of hospital stay
Time frame: 30 days after surgery
Re-admission to hospital
Re-admission to hospital due to post operative pulmonary complications
Time frame: 30 days
Cost effectiveness of spirometry utilization
Calculated as an aggregate measure considering length of hospital stay, readmission to hospital and cost of treating complications. A cost value will be assigned to each group and compared for cost-benefit relationships
Time frame: 30 days after surgery
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