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Application of self-administered postoperative prophylactic positive expiratory pressure (S-PEP) treatment in addition to conventional physiotherapy was investigated in 75 patients undergoing thoracotomy. Twenty-nine patients used a face-mask set supplied with an expiratory resistance (S-PEP group) and 27 patients used a face-mask set without resistance (control group). The observation period and postoperative treatment with the face-mask was 3 days. In the S-PEP group 13 patients developed radiographic atelectasis during the 3 postoperative days compared to eight patients in the control group (P greater than 0.05). The postoperative PaO2 in the S-PEP group was 0.36 kPa lower than in the control group (P greater than 0.05). We conclude that application of S-PEP postoperatively after thoracotomy in addition to conventional physiotherapy including early mobilization had no beneficial effect in preventing atelectasis, as evaluated by changes in blood gas tensions and chest roentgenograms.
Frølund et al. (Tue,) studied this question.