Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry (original) (raw)
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Iranian Journal of Nursing and Midwifery Research, 2016
Background: After coronary artery bypass surgery, pulmonary complications and oxygenation disorders are common, which have an important role in mortality and morbidity. Different methods are used for the improvement of pulmonary function and oxygenation, of which incentive spirometry (IS) has been investigated here. The aim of this study is to evaluate the effects of IS on arterial blood gases after coronary artery bypass graft (CABG). Materials and Methods: This was a clinical trial. Fifty patients who were candidates for CABG were chosen. The patients had been allocated to two random groups of intervention and control. The intervention was done through IS. These two groups were compared for the arterial blood gases' preoperative level, and the levels on first (after extubation), second, and third postoperative days. Results: The study findings showed that on the third postoperative day, there was a significant difference between the intervention and control groups in the mean amount of arterial blood oxygen (82.3 ± 4.7 vs. 72.7 ± 7.1, respectively, P = 0.02), arterial blood carbon dioxide (36.8 ± 2 vs. 43.7 ± 3.2, respectively, P = 0.007), and oxygen saturation (96.8 ± 1.4 vs. 90.5 ± 1.4, respectively, P = 0.03). Conclusions: This investigation shows that using IS is significantly effective in the improvement of blood arterial gas parameters.
Journal of Perioperative Medicine, 2017
Background: Postoperative respiratory complications such as hypoxemia and atelectasis remain important causes of mortality after CABG. Objective: The aim of this study was to compare the changes in arterial blood gases after the use of incentive spirometry (IS) with continuous positive airway pressure (CPAP) during intensive care unit period, after coronary artery bypass graft (CABG) also to provide an idea about which of them is more effective method following coronary artery bypass surgery in intensive care unit. Methods: 30 volunteer patients' (22 males and 8 females) who had coronary artery bypass surgery participated in this study and they were randomly selected from surgical department at intensive care unit (ICU) in National Heart Institute, Egypt, their ages ranged from 45 to 55 years. Participants were randomly assigned between two equal groups. Group 1 received incentive spirometry breathing training in addition to routine chest physiotherapy following CABG, while Group 2 received CPAP in addition to routine chest physiotherapy program following CABG. Results: The results obtained in this study indicated that, there was statistical significant increase PaO 2 and decrease in PaCO 2 after two hours of using incentive spirometry, which indicated long term effect of incentive spirometry. While there was no statistical significant improvement in arterial blood gases after two hours of using CPAP which indicated short term effect of CPAP (p<0.05). Conclusion: Incentive spirometry is superior to continuous positive airway pressure breathing to long term improve arterial blood gases following coronary artery bypass graft surgery.
KHYBER MEDICAL UNIVERSITY JOURNAL
OBJECTIVE: To compare the effects of incentive spirometry (IS) and deep breathing exercises (DBE) on pulmonary functions after coronary artery bypass grafting (CABG). METHODS: This quasi-experimental study consisted of 40 patients from both genders aged 35-60 years, undergoing CABG. Two equal groups were selected through convenient sampling. Group-A patients performed IS while group-B performed DBE. The outcome measures were values of oxygen saturation (SaO2)by pulse oximetry, and partial pressures of oxygen (pO2) and carbon dioxide (pCO2) measured by arterial blood gases (ABGs). RESULTS: Mean pO2 (mmHg) at day 1 & day 4 was 136±23.04 & 74.42±16.22 respectively in group-A (p<0.001) as compared to 127.96 ±16.99 & 70.80±10.89 respectively in group-B (p<0.001). Mean value of SaO2 at day 1 & day 4 was 98.52±1.68 & 94.07±2.36 in group-A (p<0.001) as compared to 97.90±1.99 and 95.40±2.04 in group-B (p<0.001) respectively. Mean pCO2 (mmHg) was 42.32±4.57 & 40.07±3.49 at day 1 ...
2021
Background: Postoperative pulmonary complications (PPCs) often occur after cardiac operations, and are a leading cause of morbidity, inhibit oxygenation, and increase hospital length of stay, and mortality. Although clinical evidence for PPCs prevention is often unclear and crucial, measures take place to reduce PPCs. One device usually used for this reason is the incentive spirometry (IS). The Aim of the study is to evaluate the effect of preoperative incentive spirometry to prevent postoperative pulmonary complications, improve postoperative oxygenation, and decrease hospital stay following coronary artery bypass graft (CABG) surgery patients. Methods: This was a clinical randomized prospective study. A total of 80 patients were selected as candidates for CABG at An-Najah National University Hospital, Nablus-Palestine. Patients had been randomly assigned into two groups: incentive spirometry group (IS), SI performed before surgery (study group) and control group, preoperative spir...
Heart, Lung and Circulation, 2019
Background Although the use of incentive spirometry with a deep breathing exercise (DBE) is widely used in clinical practice in patients who have undergone coronary artery bypass graft (CABG) surgery, the effect of this combination therapy has not been conclusively elucidated. The aim of this study was to investigate the effect of postoperative combined incentive spirometry and DBE versus DBE alone on inspiratory muscle strength following CABG. Method This randomised clinical trial was conducted in patients scheduled to undergo CABG surgery at Siriraj Hospital, Bangkok Thailand. The study group received incentive spirometry and DBE, and the control group received DBE only. Maximal inspiratory pressure (MIP) before surgery and at day 4 after surgery was assessed by a respiratory pressure metre. Secondary outcomes, including postoperative pulmonary complication and duration of postoperative hospitalisation, were obtained from the medical records. Results Ninety (90) patients were included, with 47 and 43 patients assigned to the study and control groups, respectively. In both groups, there was a significant reduction in MIP from preoperative baseline to postoperative day 4; however, the MIP in the incentive spirometry group had a significantly smaller reduction in MIP compared with the control group (33.0623.2% vs 47.2620.1%, respectively; p=0.006, 95% confidence interval, 3.9-23.3). There was no difference between groups regarding secondary outcomes. Conclusions Patients in the study group had significantly better recovery of inspiratory muscle strength on day 4 post-CABG than patients in the control group. There was no significant difference between groups for either postoperative pulmonary complications or length of hospital stay.
Purpose: The purpose of this study was to evaluate the efficacy of incentive spirometer (IS) and active cycle of breathing techniques (ACBT) following coronary artery bypass graft (CABG) surgery. Material and methods: Sixty male patients (41-75 years) with CABG were included in this prospective randomized study. Thirty patients underwent ACBT and 30 patients underwent IS combined with mobilization. Patients were evaluated using pulmonary function tests, arterial blood gases, 6-minute walk test (6MWT), chest radiography, and a 10-cm visual analogue scale for pain perception. Results: Fifth day post-operatively, pulmonary function variables were similarly but significantly decreased in both groups compared to pre-operative values (vital capacity decreased 15% and 18% in ACBT and IS, respectively, p<0.05). First day post-operatively, there was significant increase in oxygen saturation after the treatments in both groups. Incidence of atelectasis and pain perception was similar between the groups (p>0.05). No significant difference was found in 6MWT distance obtained before and on the fifth day following CABG surgery within and between ACBT and IS groups (p>0.05). Conclusion: Both treatments improved arterial oxygenation from the first day post-operatively. After a 5-day treatment, functional capacity was well preserved with the usage of ACBT or IS. Both physiotherapy methods had similar effects on the rate of atelectasis, pulmonary function, and pain perception. Koroner arter bypass greft cerrahisinde aktif solunum teknikleri döngüsü ve insentif spirometre Amaç: Bu çal mada koroner arter bypass greft (KABG) cerrahisinden sonra insentif spirometre (S) ve aktif solunum teknikleri döngüsünün (ASTD) etkinli inin de erlendirilmesi amaçland. Gereç ve yöntem: Bu prospektif randomize çal maya 60 erkek hasta (41-75) al nd. Mobilizasyonla kombine olarak 30 hastaya ASTD ve 30 hastaya S uyguland. Hastalar solunum fonksiyon testleri, arteryel kan gazlar , 6 dakikal k yürüme testi (6DYT), gö üs radyografi ve a r alg lamas için 10 cmlik görsel analog skalas ile de erlendirildi. Sonuçlar: Postoperatif be inci günde her iki grupta da solunum fonksiyonlar preoperatif de erlerle kar la t r ld nda anlaml olarak azald (vital kapasite ASTDde % 15, Sde % 18 azald , p<0.05). Her iki grupta da postoperatif birinci gün oksijen satürasyonu tedaviyi takiben artt (p<0.05). ki grupta atelektazi insidans ve a r alg lamas benzerdi (p>0.05). ASTD ve S gruplar nda KABGden önce ve be inci günde elde edilen 6DYT mesafesi aras nda anlaml bir farkl l k saptanmad (p>0.05). Tart ma: Her iki tedavi de postoperatif birinci günden itibaren arteryel oksijenasyonu art rd. Be günlük tedaviden sonra, ASTD veya Snin kullan m ile fonksiyonel kapasite iyi bir ekilde korundu. Her iki fizyoterapi yöntemi atelektazi insidans , pulmoner fonksiyon ve a r alg lamas n benzer ekilde etkiledi. Anahtar kelimeler: Fizyoterapi, Koroner arter bypass cerrahisi, Akci er fonksiyon testleri, Egzersiz.
Cureus
To compare the effect of incentive spirometry with Acapella (Smiths Medical Inc, Carlsbad, California) in physiotherapy after coronary artery bypass surgery. Methods A randomized controlled trial comparing incentive spirometry with Acapella was conducted in the intensive care unit of Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan. The study began from December 2017 to August 2019 after getting approval from the ethical committee of the hospital. Informed written consent was taken from all 270 patients who were included in the study. Patients who underwent coronary artery bypass graft (CABG) were divided into two groups by the lottery method. The primary end-point of the study was to check the blood gases on Day 3 after the procedure at room air and compare it with the baseline and with blood gases immediately after the procedure. SPSS 23 (IBM Corp., Armonk, NY) was used to analyze the data of this study. For qualitative variables in data such as gender, place of living, patients with any comorbidities, and education status were statistically analyzed in percentage and frequencies. For numerical variables, such as age, body mass index, blood gases values, distance covered in a six-minute walk test, and spirometry values were analyzed and statistically measured as mean and standard deviation. A P-value of less than .05 was considered significant.