Are clinical observations of breathing and pulmonary function related in pa.tients after abdominal surgery?

Author： van de Leur J. P. Smit P. Broekema A. A. van der Mark T. W. van der Schans C. P.

ISSN： 1532-5040

Source： Physiotherapy Theory and Practice, Vol.19, Iss.1, 2003-03, pp. : 45-52

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Abstract

Decline in pulmonary function after major abdominal surgery is thought to be identified in daily assessment by observation of breathing and pain intensity. Measurement of pulmonary function is usually not included in the assessment of the patient in the postoperative period. The aim of this study was to investigate the relationship between clinical observation of breathing (COB) and decline in pulmonary function and the relationship between pulmonary function and pain. Eighty-nine patients, admitted for elective major mid- and upper-abdominal surgery, participated in our study. COB covered the following parameters: 1) abdominal expansion, Side expansion, High thoracic expansion, Paradoxical breathing, Symmetry of thorax expansion, Ability to cough, Ability to huff, and Signs of mucus retention. Pain intensity was assessed at rest (VAS) and during breathing exercises and coughing (VAS-F) using a visual analogue scale. FEV₁, FVC, and PEFR were performed on the pre-operative day and for seven postoperative days.The correlation coefficient over seven days between COB and FEV₁ was 0.26 (0.002<p<0.14), and FVC 0.25 (0.001<p<0.2) and PEFR 0.19 (0.001<p<0.49). The correlation coefficient between VAS and FEV₁ was −0.22 (0.007<p<0.642), and FVC −0.22, (0.002<p< 0.548) and PEFR −0.21 (0.001<p<0.725). The correlation coefficient between VAS-F and FEV₁ was −0.18 (0.008<p<0.581), and FVC −0.20, (0.001<p<0.569) and PEFR −0.22 (0.001< p<0.794). In conclusion, a poor correlation is found between clinical observation of breathing and pulmonary function after abdominal surgery.