Respiratory physiotherapy and postoperative pulmonary complications in cardiac surgery: A systematic review with meta-analysis

Abstract

Introduction: Postoperative pulmonary complications are a significant cause of morbidity and mortality following cardiac surgery. In this context, respiratory physiotherapy is widely used to prevent or reduce these complications. Objective: To describe the efficacy of respiratory physiotherapy and ventilatory strategies in reducing postoperative pulmonary complications in patients undergoing cardiac surgery. Methods: A systematic database search was conducted in accordance with PRISMA 2020 recommendations. Randomized clinical trials published between 2020 and 2026 were included, involving patients undergoing cardiac surgery and respiratory physiotherapy interventions in the pre-operative period, post-operative period, or both. The outcomes analyzed were the incidence of pulmonary complications, duration of mechanical ventilation, length of hospital stay, and recovery of pulmonary function. Results: Interventions, including inspiratory muscle training, positive airway pressure, breathing exercises, bronchial hygiene techniques, and early mobilization—reduced the incidence of pulmonary complications, the duration of mechanical ventilation, and the length of hospital stay, while also promoting improvements in pulmonary function and functional capacity during recovery. Conclusion: Respiratory physiotherapy is effective in preventing and reducing pulmonary complications after cardiac surgery, contributing to better clinical outcomes, shorter hospital stays, and a potential reduction in healthcare costs.