Effect of vibratory positive expiratory pressure on pulmonary function after lung resection surgery: a randomized trial

Abstract

서론: 진동형 양압호기의 사용은 폐절제술 환자에서 수술 후 폐기능 회복에 도움이 될 것으로 예상되나 이에 대한 임상적인 연구 결과는 부족하다.

방법: 비디오 보조 흉강경술 방법으로 폐절제술이 예정된 49명의 환자를 대상으로 기존의 유발 폐활량기와 아카펠라 기구를 이용한 진동형 양압호기를 사용하는 군과 유발 폐활량기만을 사용하는 군에 무작위 배정하여 수술 후 3일째 1초간 강제호기량을 비교하였다.

결과: 수술 후 3일째 측정한 1초간 강제호기량은 아카펠라를 사용한 군에서58.88±16.39%, 유발 폐활량기만을 사용한 군에서 55.43±18.71%였다 (P=0.427). 아카펠라를 사용한 군에서 수술 후 재원일수는5.6±2.2일, 사용하지 않은 군에서는 4.4±1.6일이었다 (P=0.038).

Background: There are limited data whether vibratory positive expiratory pressure improves postoperative pulmonary function recovery in patients undergoing pulmonary resection surgery.

Methods: We randomly assigned 49 patients undergoing video-assisted thoracoscopic pulmonary resection surgery to use either vibratory positive expiratory pressure using Acapella® device as well as incentive inspirometry (the Acapella group) or incentive inspirometry alone (the control group) postoperatively. Primary end point was forced expiratory volume in 1 second (FEV1, percentage of reference value: FEV1 %) on the third postoperative day. Analyses were performed on an intention-to-treat basis.

Results: There was no significant between-group difference in the primary end point, which was 58.88±16.39% in the Acapella group and 55.43±18.71% in the control group (P=0.427). Patients in the Acapella group had significantly longer postoperative length of stay (5.6±2.2 vs. 4.4±1.6 days, P=0.038).

Conclusions: The use of vibratory positive expiratory pressure using Acapella device had no significant improvement in postoperative pulmonary function in patients undergoing pulmonary resection surgery. Patients who used the Acapella device in the early postoperative period within three days showed significant longer postoperative hospital length of stay. (ClinicalTrials.gov number, NCT01826136.)