Impact of Pulmonary Rehabilitation on Hospitalization Duration, IL-6 Levels, and Respiratory Muscle Power in Hospitalized Community-Acquired Pneumonia Patients
DOI:
https://doi.org/10.36497/jri.v42i1.276Keywords:
Community pneumonia, Interleukin-6, Duration of hospitalization, Chest physiotherapyAbstract
Background: Pneumonia is acute inflammation of the lung parenchyma. The long duration of hospitalization is associated with increased morbidity, nosocomial infections and treatment costs.
Methods: The study was conducted from May to November 2019 at Saiful Anwar Hospital, Malang, with 40 pneumonia patients in the non-intensive community inpatient room divided into 2 groups. The treatment group performed pulmonary rehabilitation measures consisting of breathing exercise, effective coughing techniques, clapping, postural drainage and respiratory muscle training using spirometry incentives.
Results: The duration of hospitalization for the treatment group was 2.25 days shorter (p<0.001). The average IL-6 level in the 5th day of the treatment group was lower than without treatment, that was 54.43 pg/ml (p=0.221). The mean of pressure threshold loading in the group without treatment was 31.5 cmH2O on first day and 36.35 cmH2O on the 5th day (p <0.001) and on first day treatment group was 32.9 cmH2O and 39.35 cmH2O on the 5th day (p=0.001), and the mean value of the 5th day of the treatment group was higher than without treatment (P=0.015). the mean of the 5th day of the treatment group was higher than without treatment (p=0.06).
Conclusion: Pulmonary rehabilitation as adjunctive therapy shortens the duration of hospitalization. In both groups there was a decrease in IL-6 levels on the 5th day compared to zero and the lower IL-6 levels were not significant in the treatment group. There was a significant increase in the value of pressure threshold loading inspiration and expiration day fivecompared to day zero in the two groups and there was a significant increase in the Pressure Threshold Loading Inspiration mean treatment group compared to no treatment on the 5th day, but the Pressure Threshold Loading Expiration rate showed no significant increase.
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References
Wibisono MJ, Winariani, Hariadi S. Pneumonia. In: Buku Ajar Ilmu Penyakit Paru. Surabaya: IPP FK. Unair RSUD Dr. Soetomo; 2010. p. 153–74.
Perhimpunan Dokter Paru Indonesia. Pneumonia Komunitas: Pedoman Diagnosis dan Penatalaksanaan di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2014. 3–35 p.
Pallás Beneyto LA, Rodríguez Luis O, Saiz Sánchez C, Coltell O, Bautista Rentero D, Miguel Bayarri V. [Prognostic value of interleukin 6 for death of patients with sepsis]. Med Clin (Barc). 2016;147(7):281–6.
Kishimoto T. IL-6: from its discovery to clinical applications. Int Immunol. 2010;22(5):347–52.
Yang M, Yan Y, Yin X, Wang BY, Wu T, Liu GJ, et al. Chest physiotherapy for pneumonia in adults. Cochrane database Syst Rev. 2013;(2):CD006338.
Carratalà J, Garcia-Vidal C, Ortega L, Fernández-Sabé N, Clemente M, Albero G, et al. Effect of a 3-step critical pathway to reduce duration of intravenous antibiotic therapy and length of stay in community-acquired pneumonia: a randomized controlled trial. Arch Intern Med. 2012;172(12):922–8.
José A, Dal Corso S. Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial. J Physiother. 2016;62(2):96–102.
Bacci MR, Leme RCP, Zing NPC, Murad N, Adami F, Hinnig PF, et al. IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients. Brazilian J Med Biol Res = Rev Bras Pesqui medicas e Biol. 2015;48(5):427–32.
Andrijevic I, Matijasevic J, Andrijevic L, Kovacevic T, Zaric B. Interleukin-6 and procalcitonin as biomarkers in mortality prediction of hospitalized patients with community acquired pneumonia. Ann Thorac Med. 2014;9(3):162–7.
Martin-Loeches I, Valles X, Menendez R, Sibila O, Montull B, Cilloniz C, et al. Predicting treatment failure in patients with community acquired pneumonia: a case-control study. Respir Res. 2014;15(1):75.
Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):a016295.
Mat-Nor MB, Md Ralib A, Abdulah NZ, Pickering JW. The diagnostic ability of procalcitonin and interleukin-6 to differentiate infectious from noninfectious systemic inflammatory response syndrome and to predict mortality. J Crit Care. 2016;33:245–51.
Enright S, Chatham K, Ionescu AA, Unnithan VB, Shale DJ. Inspiratory muscle training improves lung function and exercise capacity in adults with cystic fibrosis. Chest. 2004;126(2):405–11.
Ramírez-Sarmiento A, Orozco-Levi M, Güell R, Barreiro E, Hernandez N, Mota S, et al. Inspiratory muscle training in patients with chronic obstructive pulmonary disease: Structural adaptation and physiologic outcomes. Am J Respir Crit Care Med. 2002;166(11):1491–7.
Geddes EL, Reid WD, Brooks D, O’Brien K, Crowe J. A primer on inspiratory muscle trainers. Buyers Guide for the European Respiratory Society. 2006;59–67.
Liu W, Mu X, Wang X, Zhang P, Zhao L, Li Q. Effects of comprehensive pulmonary rehabilitation therapy on pulmonary functions and blood gas indexes of patients with severe pneumonia. Exp Ther Med. 2018;16(3):1953–7.
Weiner P, Magadle R, Berar-Yanay N, Davidovich A, Weiner M. The cumulative effect of long-acting bronchodilators, exercise, and inspiratory muscle training on the perception of dyspnea in patients with advanced COPD. Chest. 2000;118(3):672–8.
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