EFFECTIVENESS OF PULMONARY EXPANSION THERAPY IN REDUCING POSTOPERATIVE PULMONARY COMPLICATIONS AMONG MAJOR ABDOMINAL SURGERY PATIENTS AT SVBP HOSPITAL, MEERUT

Abstract

Background Postoperative pulmonary complications (PPCs) are among the most frequent and serious complications following major abdominal surgery, contributing significantly to postoperative morbidity, mortality, prolonged hospitalization, and increased healthcare expenditure. Surgical trauma, general anaesthesia, postoperative pain, diaphragmatic dysfunction, and prolonged immobilization impair pulmonary mechanics, leading to atelectasis, pneumonia, hypoxemia, bronchospasm, and respiratory failure. These complications delay recovery and adversely affect patients' quality of life. Pulmonary Expansion Therapy (PET), comprising deep breathing exercises and incentive spirometry, has emerged as an evidence-based, non-invasive intervention that promotes lung expansion, improves alveolar ventilation, facilitates airway clearance, and reduces postoperative pulmonary complications. However, limited evidence is available regarding its effectiveness among major abdominal surgery patients in Indian tertiary care settings. Objectives 1.To develop and validate Pulmonary Expansion Therapy (PET) for the prevention of postoperative pulmonary complications among patients undergoing major abdominal surgery. 2.To evaluate the effectiveness of Pulmonary Expansion Therapy in reducing postoperative pulmonary complications among patients in the experimental group. 3.To compare postoperative pulmonary complications between the experimental and control groups. 4.To determine the association between postoperative pulmonary complications and selected demographic variables. Methodology A quantitative research approach with a quasi-experimental pre-test–post-test control group design was adopted. One hundred patients undergoing major abdominal surgery were selected using a purposive sampling technique and allocated equally into experimental (n=50) and control (n=50) groups. Patients in the experimental group received structured Pulmonary Expansion Therapy consisting of deep breathing exercises and incentive spirometry in addition to routine postoperative care, whereas the control group received routine postoperative care alone. Postoperative pulmonary complications were assessed using the Melbourne Group Scale (Version 2). Descriptive and inferential statistics, including paired t-test, independent t-test, Chi-square test, and Fisher's exact test, were used to analyse the data. Results Among the 100 participants, the experimental and control groups were comparable with respect to baseline demographic and clinical characteristics. Before the intervention, the majority of participants in both groups had moderate to severe postoperative pulmonary complications. Following Pulmonary Expansion Therapy, 52% of participants in the experimental group improved to the mild postoperative pulmonary complication category, while only 2% remained in the severe category. In contrast, the majority of participants in the control group (74%) continued to experience moderate postoperative pulmonary complications after receiving routine postoperative care. The mean postoperative pulmonary complication score in the experimental group significantly decreased from 20.20 ± 4.17 during the pre-test to 10.72 ± 5.31 during the post-test, with a mean reduction of 9.48 ± 3.24 (t = 20.69, p < 0.001). In comparison, the control group demonstrated a smaller reduction in mean score from 18.88 ± 4.63 to 16.22 ± 4.74, with a mean reduction of 2.66 ± 1.78 (t = 10.57, p < 0.001). The post-test comparison between the two groups revealed a statistically significant difference (t = 5.46, p < 0.001), confirming that Pulmonary Expansion Therapy was significantly more effective than routine postoperative care in reducing postoperative pulmonary complications. Furthermore, no statistically significant association was observed between postoperative pulmonary complication scores and selected demographic or clinical variables (p > 0.05). Conclusion Pulmonary Expansion Therapy is an effective, safe, economical, and evidence-based nursing intervention for reducing postoperative pulmonary complications among patients undergoing major abdominal surgery. Integration of structured PET into routine postoperative nursing care may improve pulmonary function, accelerate recovery, reduce hospital stay, and enhance overall patient outcomes.