Evidence map›Paper›PMID 14670881›Full record

SynthesisBMJ (Clinical research ed.)2003

Prophylactic respiratory physiotherapy after cardiac surgery: systematic review.

Patrick Pasquina, Martin R Tramèr, Bernhard Walder

Registry-linked trialOpen access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02278835 (To Analyze the Effectiveness of Respiratory Physiotherapy Techniques in the Post Operative Mitral Valve), which is not on this map. Cited by 37 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 6 pooled it
7.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02278835 nacompletednot on this mapstarted 2009, after this paper: background citation

To Analyze the Effectiveness of Respiratory Physiotherapy Techniques in the Post Operative Mitral Valve

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2009 to 2014Enrolled110ConditionsMitral Valve DiseaseArmsbreathing exercises, incentive spirometry, Intermittent positive pressure breathing, Continuous positive airway pressure
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 6 syntheses or guidelines pooled it, 241 citations in OpenAlex.

  1. Pooled it
  2. Preoperative physical therapy for elective cardiac surgery patients.The Cochrane database of systematic reviews · 2012
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Postoperative pulmonary infections.BMJ clinical evidence · 2008
    Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Review
  14. Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Patrick PasquinaDivision of Surgical Intensive Care, Department of Anaesthesiology, Pharmacology and Surgical Intensive Care, Geneva University Hospitals, Switzerland. Patrick.Pasquina@hcuge.ch
Martin R Tramèr
Bernhard Walder
Geneva College · USUniversity Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess whether respiratory physiotherapy prevents pulmonary complications after cardiac surgery. DATA SOURCES: Searches through Medline, Embase, Cinahl, the Cochrane library, and bibliographies, for randomised trials comparing any type of prophylactic respiratory physiotherapy with another type or no intervention after cardiac surgery, with a follow up of at least two days, and reporting on respiratory outcomes. REVIEW

methodsInvestigators assessed trial validity independently. Information on study design, population, interventions, and end points was abstracted by one investigator and checked by the others.

results18 trials (1457 patients) were identified. Most were of low quality. They tested physical therapy (13 trials), incentive spirometry (eight), continuous positive airway pressure (five), and intermittent positive pressure breathing (three). The maximum follow up was six days. Four trials only had a no intervention control; none showed any significant benefit of physiotherapy. Across all trials and interventions, average values postoperatively were: incidence of atelectasis, 15-98%; incidence of pneumonia, 0-20%; partial pressure of arterial oxygen per inspired oxygen fraction, 212-329 mm Hg; vital capacity, 37-72% of preoperative values; and forced expiratory volume in one second, 34-72%. No intervention showed superiority for any end point. For the most labour intensive intervention, continuous positive airway pressure, the average cost of labour for each patient day was 27 euro (pound 19; 32 dollars).

conclusionsThe usefulness of respiratory physiotherapy for the prevention of pulmonary complications after cardiac surgery remains unproved. Large randomised trials are needed with no intervention controls, clinically relevant end points, and reasonable follow up periods.

Indexed as

HumansLung DiseasesPhysical Therapy ModalitiesPostoperative CarePostoperative ComplicationsRandomized Controlled Trials as TopicSample SizeThoracic Surgical ProceduresTreatment Outcome

Identifiers

PMID14670881
PMCPMC292987
OpenAlexW1997156786

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.