Efficacy of non-invasive ventilatory support in the physiotherapy treatment after pulmonary lobectomy

Lung disease is a rising problem worldwide. Generally, lung disease can be broadly classified as cancerous or non-cancerous. Regardless of the type of disease, lung conditions generally experience problems with breathing and chest pain, as the diseased lung is not able to function properly. The human lungs are divided into sections called lobes. The right lung has three lobes and the left long has two lobes. A pulmonary lobectomy is an operation where one of the lobes of the lungs is removed (a bi-lobectomy is where two lobes are removed). This is an important procedure when only part of the lung is affected, as once the diseased lobe (or lobes) is removed the remaining lung tissue can work normally. The most common complications of a lobectomy are atelectasis (where part of the lung collapses) and pneumonia (a condition which involves swelling (inflammation) of the lung tissue). In order to try and prevent this, patients see a physiotherapist to learn deep-breathing and controlled coughing exercises in order to help the lungs to re-inflate after surgery and heal faster. cPAP (continuous positive airway pressure) and NIMV (non-invasive mechanical ventilation) are methods of non-invasive ventilatory (breathing) support which deliver air through a face mask in order to keep the airways open. Currently, these techniques are not really used in rehabilitation after a pulmonary lobectomy, although they could play a key role in the re-expansion of the lung. The aim of this study is to find out whether combining non-invasive ventilatory support and standard physiotherapy is more effective than standard physiotherapy alone after pulmonary lobectomy.