The Effect of Different Lung Expansion Training Methods on Pulmonary Complications and Pulmonary Function in Patients Receiving Lobectomy

Lung expansion is an important clinical intervention. It plays an important role in the prevention of postoperative pulmonary complication and the recovery of pulmonary function. Few researches focused on the long-term effect of the lung expansion on the prevention of pulmonary complication and the recovery of pulmonary function. This study was to investigate the effect of the different lung expansion training methods on pulmonary complication and pulmonary function in patients receiving lobectomy. In this study, a repeated-measure longitudinal quai- experimental study was employed. The research took place in the medical-surgical units of a medical center in Taipei. All elective probable lobectomy patients were divided into three groups, each receiving preoperative bedside testing of pulmonary function and instruction in the use of three randomly assigned lung expansion methods (deep breath exercise, TrifloII, or Couch2). Repeated lung function tests were provided preoperatively and postoperatively at days 2, 4, 6, two weeks, 1.5 months, and 3 months. And six-minute walk was tested the same time as lung function except postoperatively at days 2, 4, 6. All the patients’ postoperative pulmonary complications, lung function recovery were recorded. Fifty-four patients met the criteria were included. There were no statistical significant differences between three groups in postoperative pulmonary complications, except more Chest X-ray abnormal finding of the TrifloII group postoperatively at days 7 to 3 months. There were no statistical significant differences between three groups in postoperative pulmonary function, except higher dyspnea scale score of the TrifloII group after six-minute walk test. Furthermore, different lung expansion training methods, gender, diagnosis, past cardiopulmonary disease history, duration of anesthesia, blood loss in operation, surgical methods, length of the surgical site, religious, retention time of chest tube, duration of ventilator use, body mass index, length of ICU stay, preoperative pulmonary function(%FVCpred, %PFpred, and %FEV1pred ), frequency of the lung expansion training, and the effort of the lung expansion training would be the influential factors to the recovery of pulmonary function in statistics. The changes SpO2 and heart rate after six-minute walk test would be the predictive indicators of the recovery of pulmonary function. The study showed deep breath exercise group was the most cost-effective lung expansion training in lobectomy patients. Otherwise, some of the lobectomy patients lack the correct deep breath exercise skill after training or surgery. We suggest deep breath exercise training for all preoperative and postoperative lobectomy patients and incentive spirometry as the alternative if lacking the correct deep breath exercise skill.