Evid Based Nurs doi:10.1136/eb-2012-101199
  • Adult nursing
  • Systematic review and meta-analysis

Preoperative physical therapy reduces risk of postoperative atelectasis and pneumonia in people undergoing elective cardiac surgery

  1. Arne Tenling2
  1. 1School of Health and Medical Sciences, Örebro University, Örebro, Sweden
  2. 2Department of Cardiothoracic Anesthesia, Uppsala University Hospital, Uppsala, Sweden
  1. Correspondence to: Dr Elisabeth Westerdahl
    Centre for Health Care Sciences, Örebro University Hospital, Örebro 701 85, Sweden; elisabeth.westerdahl{at}

Commentary on: Hulzebos EH, Smit Y, Helders PP, et al. Preoperative physical therapy for elective cardiac surgery patients. Cochrane Database Syst Rev 2012;11:CD010118.

Implications for practice and research

  • Cardiac surgery patients are at risk of postoperative pulmonary complications.

  • The incidence of postoperative pulmonary complications varies in the literature, because of inconsistent definitions for postoperative pulmonary complication.

  • More large-scale randomised controlled trials are needed to determine the value of preoperative physical therapy in cardiac surgery patients.


Postoperative pulmonary complications are a common cause of morbidity and mortality after cardiac surgery. The reasons for the lung function impairment are multifactorial and include anaesthesia, cardiopulmonary bypass, the surgery itself, analgesia and postoperative immobility. The reported incidence varies in the literature, depending on the specific criteria used for the definition of a postoperative pulmonary complication and the diagnostic techniques used to detect them. Efforts have been made to identify those patients who have a higher risk of developing postoperative pulmonary complications. Physical therapy …

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