“Despite advances in perioperative care in the last few decades, postoperative pulmonary complications (PPCs) are probably the leading cause of morbidity and mortality in adults undergoing chest and abdominal surgery. PPCs and cardiac complications are commonly regarded as the two major causes of perioperative problems in selected groups of patients undergoing these high-risk surgical procedures. However, PPCs are more common than postoperative cardiac complications and play a bigger role in mortality and healthcare costs. Despite these factors, the natural history of PPCs and the necessity of preventive strategies have not been well recognized in studies to date.”

“In high-volume centres, many patients usually wait longer than two weeks for their elective surgery. Preoperative IMT could be easily performed in the outpatient setting (for example at
home or in a local rehabilitation clinic) under the supervision of a physiotherapist, and with no adverse events reported. We found evidence that preoperative IMT is associated with a
reduction of postoperative atelectasis, pneumonia, and duration of hospital stay. Preoperative IMT therefore appears to be a suitable preparation for elective surgery, especially for people on the waiting list for high-risk major cardiac and abdominal surgery. It is important to note that as the quality of evidence is low to moderate, the potential for overestimation of treatment effect needs to be considered when interpreting the present findings.”

Katsura, Morihiro et al. “Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery.” The Cochrane database of systematic reviews vol. 2015,10 CD010356. 5 Oct. 2015, Free Full Text