Lindner 1987.
| Methods | Study done at Ulm University Clinic, Ulm, Germany | |
| Participants | Participants undergoing elective major upper abdominal surgery; all were moderately healthy patients Control group: 17 participants; male/female: 6:11; age, years: 65 (range 52‐77); weight, kg: 65 (range 47‐85) Intervention group: 17 participants; male/female: 12:5; age, years: 66 (range 50‐77); weight, kg: 66 (50‐95) |
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| Interventions | Control group: standard physiotherapy (deep breathing and coughing) at 3‐hourly intervals during daytime for 48 hours Intervention group: standard physiotherapy as well as continuous CPAP at FiO2 of 0.35, 12 cm H2O, 3 hours per day for 5 days |
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| Outcomes | Duration of intervention: 5 days Duration of follow‐up: 5 days All participants received same analgesic routine All‐cause mortality: none reported Major respiratory complications as defined in the study by radiograph (3rd day): Atelectasis: control group, 4/17; intervention group, 0/17 Consolidation: control group, 1/17; intervention group, 1/17 Need for tracheal intubation and invasive ventilation: none in either group Admission to ICU/IMC: intervention group: not reported Length of stay in hospital: not reported Cardiovascular complications (myocardial infarction, unstable angina, acute cardiac failure, arrhythmia): none reported Other postoperative complications (wound infection, anastomotic leak, renal failure): none reported Adverse effects of the intervention (pulmonary aspiration, upper airway or facial injury): not reported |
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| Notes | CPAP = continuous positive airway pressure FiO2 = inspired oxygen fraction ICU = intensive care unit IMC = intermediate care unit |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | 'Randomized' into 2 groups |
| Allocation concealment (selection bias) | High risk | No description for it (randomly assigned into 2 groups) |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Not stated |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | "Pulmonary function measurements were performed by a researcher who was not aware of which group the patients were in" Radiologist interpreted x‐ray films "without knowledge of whether the patient was receiving CPAP or not" |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Probably OK |
| Selective reporting (reporting bias) | Unclear risk | Not sure |
| Other bias | Unclear risk | Not sure |