Effects of ABDOWN Positioning in Postoperative Care After Major Upper Abdominal Surgery: A Randomized Controlled Pilot Study

Monika Fagevik Olsen, Cecilia Engström Mattisson, Ewa Gruber-de Sousa
Purpose:

This pilot randomized controlled trial (RCT) aimed to evaluate the effects of daily ABDOWN positioning on respiratory function, circulatory parameters, and length of hospital stay (LOS) in patients undergoing major upper abdominal surgery.

Methods:

Fifty patients scheduled for major open upper abdominal surgery were randomized into two groups: an intervention group (ABDOWN positioning) and a control group receiving standard postoperative care. Patients in the intervention group performed daily ABDOWN positioning, either lying prone or standing and leaning forward, with assistance from healthcare personnel for a minimum of 10 minutes starting from the first postoperative day. Measurements were taken on postoperative days 2 and 5, and primary outcomes included spirometry parameters (FEV1, FVC, PEF), peripheral oxygen saturation (SpO2), respiratory rate, and LOS

Results:

Of the 50 patients, 20 were excluded due to cancellations or logistical reasons, leaving 30 participants (15 in each group). The intervention group showed no significant improvements in oxygenation (SpO2), lung function (FVC, FEV1, PEF), or respiratory rate between days 2 and 5 compared to the control group (p>0.05). However, the intervention group had a shorter average LOS (11 days) compared to the control group (13.8 days), although this difference did not reach statistical significance (p=0.164). No adverse events were reported during the intervention.

Conclusion(s):

This pilot study did not demonstrate significant differences between ABDOWN positioning and standard care in terms of respiratory function or oxygenation postoperatively. However, ABDOWN was feasible to implement in the early postoperative period and was well-tolerated by patients, with no adverse events. While this study was not powered to detect large differences, it provides preliminary insights into the potential benefits of ABDOWN in postoperative care after major abdominal surgery.

Implications:

This is the first study to evaluate the effect of ABDOWN positioning after major upper abdominal surgery. The lack of adverse events and the feasibility of the intervention suggest that further research with larger sample sizes is warranted to explore its potential benefits in postoperative recovery.

Funding acknowledgements:
This study was supported by grants from ALF, regional and local FoU funding, agreement (ALFGBG-965563).
Keywords:
Abdown,
Major upper abdominal surgery
Postoperative care, Respiratory function, Randomized controlled trial, Length of stay (LOS)
Primary topic:
Cardiorespiratory
Second topic:
Critical care
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethics approval was obtained from the Regional Ethics Review Board in Gothenburg
Provide the ethics approval number:
Dnr 2021-06877-01
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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