Kulkarni 2010.
| Methods | Design: randomized controlled trial. Multicentre or single‐centre: not reported. Period: not reported. Sample size: not reported. Follow up: 1‐7 days postoperatively | |
| Participants | N = 80 randomized and 76 analysed Sex: not reported Mean age: not reported Inclusion criteria: (i) over 18 years of age; and (ii) undergoing major abdominal general surgery (defined as deliberate breach of peritoneum), or major urological surgery, with ASA (American Society of Anesthesiologists) grades I–IV requiring any length of hospital stay Exclusion criteria: if they were ASA grade V, had suspected or established respiratory infection, were likely to undergo surgery to be performed within 2 weeks of initial assessment, had previous spontaneous pneumothorax Setting: not reported |
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| Interventions | Group A: no training (n=20) Group B: deep breathing exercises (n=20) Group C: incentive spirometry Spiroball® (n=20) Group D: Powerbreathe® |
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| Outcomes | Change in all respiratory variables following training before surgery and after surgery; length of stay of patients, time in ICU postoperatively, time on a ventilator, respiratory rates and oxygen saturations from charts at a fixed time postoperatively off oxygen, proven respiratory infection (positive sputum culture) and other pulmonary complications | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Computer‐generated numbers |
| Allocation concealment (selection bias) | Low risk | Sealed opaque envelopes |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Investigators were not blinded; however blinding for participants was not reported |
| Blinding of outcome assessment (detection bias) All outcomes | High risk | Outcome assessors were not blinded to treatment allocation |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Less than 20% of the total of the participants |
| Selective reporting (reporting bias) | Low risk | No evidence |
| Other bias | High risk | Conflict of interest: Professor Alison McConnell acts as a consultant to HaB Ltd |