Preoperative RESpiratory Training and MOBilization to Prevent Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery

Exclusion Criteria

• •Patients unable to understand the instructions and/or to perform the proposed training program (i.e., poor comprehension, chest pain)
• •COPD GOLD Grade III and IV, lung fibrosis, documented bullae, severe emphysema, pneumothorax
• •Patient with chest pain or at risk of pneumothorax
• •Previous lung surgery
• •Bilateral lung procedures
• •Emergent surgery or organ transplant
• •Planned mechanical ventilation after surgery
• •Uncontrolled asthma
• •Coronary heart disease with angina grade 3 or 4 Canadian Cardiovascular Society
• •documented pulmonary arterial hypertension \>25mmHg mean pulmonary arterial pressure (PAP) at rest or \> 40 mmHg systolic PAP (estimated by ultrasound)
• •Documented or suspected neuromuscular disease (thymoma, myasthenia, myopathies, muscular dystrophies, others)
• •Intracranial injury or tumor
• •Persistent hemodynamnic instability, intractable shock
• •Pregnancy (excluded by anamnesis and/or laboratory analysis)
• •Enrollment in another interventional study or refusal of informed consent
• •Presence of one of the adverse events, listed as PPCs (aspiration, respiratory failure, pneumonia, atelectasis, cardiopulmonary edema, pleural effusion, pneumothorax)
• •Pleural surgery only, sympathectomy surgery only, chest wall surgery only, mediastinal surgery only, lung transplantation