Fisioterapia e as complicações pulmonares no pós-operatório de esofagectomia: uma revisão integrativa da literatura
Physiotherapy and postoperative pulmonary complications after esophagectomy: an integrative literature review
Objetivo: Identificar fatores que influenciam no desenvolvimento das principais complicações pulmonares no pós-operatório de esofagectomias e as condutas fisioterápicas na prevenção e tratamento das mesmas. Métodos: Revisão integrativa realizada através de busca bibliográfica nas bases de dados PubMed, Biblioteca Virtual em Saúde, Cochrane e Scielo, nos últimos 10 anos, nos idiomas português e inglês, incluindo artigos que abordassem a fisioterapia no pré e pós-operatório de esofagectomias, principais complicações pulmonares e fatores de risco. Resultados: Pneumonia, atelectasia, derrame pleural, SARA e quilotórax foram as complicações identificadas e os fatores influenciadores foram nível de atividade física, administração de corticoides, perda sanguínea intraoperatória, idade, duração da cirurgia, localização do tumor, VEF1 < 65% do predito, DPOC e fisioterapia respiratória. A realização da fisioterapia no pré e pós-operatório mostrou redução na incidência de complicações, melhora na função pulmonar, tempo de antibioticoterapia, permanência de dreno torácico e taxa de reintubação (p<0,05). Porém, não houve resultados significativos na redução do tempo de hospitalização.
Objective: To identify the factors which influence the development of the major pulmonary complications in the postoperative of esophagectomies and conducts of physical therapy in the prevention and treatment of the same. Methods: Integrative review conducted through the literature search in the following databases: PubMed, VirtualHealth Library, Cochrane and Scielo, over the last 10 years, in Portuguese and English, including articles related to physiotherapy in pre and postoperative of esophagectomy surgery, the major pulmonary complications and risk factors. Results: Pneumonia, atelectasis, pleural effusion, ARDS and chylothorax were identified of the main complications and influencing factors were level of physical activity, corticoid administration, intraoperative blood loss, age, duration of surgery, tumor location, FEV1 < 65% of the predicted, COPD and respiratory physiotherapy. Conclusion: The physical therapy in pre and postoperative showed reduced incidence of complications, improve lung function, duration of antibiotic therapy, presence of thoracic drain and reintubation rate (p<0,05). However there were no significant results in reducing the length of hospitalization.
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