Peri-operative chest physiotherapy for paediatric cardiac patients: a systematic review and meta-analysis

Beningfield, A., and Jones, A. (2018) Peri-operative chest physiotherapy for paediatric cardiac patients: a systematic review and meta-analysis. Physiotherapy, 104 (3). pp. 251-263.

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Background: Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population.

Objective: To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD.

Data sources: A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016.

Eligibility criteria: English peer-reviewed articles that utilised CPT before or after cardiac surgery for paediatric CHD. Systematic reviews were excluded.

Data extraction and synthesis: Completed by two independent researchers using the Crowe Critical Appraisal Tool. Data were collated using a piloted data extraction tool. Mix Version was used for meta-analysis, and data were extracted using an odds ratio (with a random effects model).

Results: Eleven studies met the inclusion criteria for the systematic review. Variable results were found regarding the effect of CPT on peripheral oxygen saturation and pain. Meta-analysis showed that CPT did not prevent pneumonia (odds ratio (OR) 2.01; 95% confidence interval (CI) 0.80 to 5.05; P = 0.13), and did not prevent or treat atelectasis (OR 1.27; 95% CI 0.18 to 8.87; P = 0.81).

Limitations: There was a lack of high-quality studies. The included studies were comprised of heterogeneous treatment, limiting external validity.

Conclusion: Active therapies such as mobilisation, deep breathing and incentive spirometry were more effective than passive treatment. Percussion led to oxygen desaturation, and percussion, vibration and suctioning increased the risk of developing atelectasis.

Item ID: 52971
Item Type: Article (Research - C1)
ISSN: 1873-1465
Keywords: physical therapy; physical therapy modalities; peri-operative care; heart diseases; pre-operative care; postoperative care
Copyright Information: 0031-9406/© 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Date Deposited: 05 Apr 2018 04:36
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 20%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3213 Paediatrics > 321302 Infant and child health @ 40%
42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420106 Physiotherapy @ 40%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 75%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 25%
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