Respiratory Muscle Training in Malnourished Patients Undergoing Abdominal Surgery

N/ACompletedNCT02200198

University of Sao Paulo General Hospital45 enrolled

Overview

Malnutrition affects 50% of hospitalized patients around the world and causes changes in respiratory muscles predisposing the development of pulmonary complications probable, because of the ineffectiveness of cough. How the training of respiratory muscles can improve the effectiveness of cough, malnourished patients could benefit from this train however, the training of the muscles in malnourished patients has not been tested for safety or efficiency. So, the aim of this study is to assess the safety and efficiency of respiratory muscle training to improve the potency of cough in malnourished patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Undernutrition Surgery

Interventions

Inspiratory muscle trainingOTHER

Patient performs training for 30 minutes per day, during 7 consecutive days, using a Threshold for Inspiratory Muscle Training with a load of 30% of maximal inspiratory pressure assessed by digital peak respiratory pressure monitor

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * hospitalized malnourished patients (BMI ≤ 20 Kg/m2, loss of body weight ≥ 10% unintentional, or serum albumin \<3.5 g/dL) * candidate to elective abdominal surgery * ability to perform all evaluations and training Exclusion Criteria: * previous respiratory disease * necessity of over than 48h of mechanical ventilation * reoperation

Outcomes

Primary Outcomes

Expiratory peak flow in spirometry

Assessed as expiratory peak flow in spirometry

Time frame: on the 8th day of protocol (after 7 dyas of training)

Secondary Outcomes

Maximum respiratory pressures

Assessed by digital peak respiratory pressure monitor as maximum inspiratory pressure and maximum expiratory pressure

Time frame: on the 8th day of protocol (after 7 days of training)

Postoperative pulmonary complication

The following pulmonary complications were considered: atelectasis with clinical consequences, hypoxemia with oxygen saturation \<85%, and need for supplemental oxygen, pneumonia and acute respiratory failure. The diagnosis of complication was performed by a physician who was blinded to the intervention group.

Time frame: participants will be followed for the duration of hospital stay after surgery, an expected average of 10 days