Effect of Coughing Exercises Versus Incentive Spirometry on Respiratory Function and Recovery in Children After Cardiac Surgery.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Coughing Exercises, Incentive Spirometry, Standard Postoperative Care.
- Who it may be relevant to
- Registry conditions: Congenital Heart Disease (CHD), Postoperative Respiratory Dysfunction, Postoperative Recovery After Cardiac Surgery. Basic parameters: 6 years — 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Iraq
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effect of Coughing Exercises Versus Incentive Spirometry on Respiratory Outcomes and Postoperative Recovery Among Children Undergoing Cardiac Surgery.
Overview
This study examines the effects of coughing exercises and incentive spirometry (IS) on lung function and recovery in children who undergo heart surgery. The main goals are to see: How coughing exercises and IS affect breathing and lung function after surgery? How these exercises influence overall recovery after surgery? Children who participate will be randomly assigned to one of three groups: coughing exercises, IS, or standard care. Those in the exercise groups will perform their assigned breathing exercises every 3 hours for the first 3 days after surgery. Daily check-ups will be conducted to monitor their progress, lung function, and oxygen levels. The study will measure breathing ability, oxygen levels, and recovery milestones to find out which method is most effective in preventing lung complications and helping children recover faster.
Detailed description
This clinical trial evaluates the effects of coughing exercises and incentive spirometry (IS) on postoperative respiratory outcomes and recovery in children undergoing elective cardiac surgery with cardiopulmonary bypass.
The study aims to answer:
How do coughing exercises and IS influence lung function and breathing after surgery? How do they affect overall recovery, including physical comfort, oxygenation, and prevention of pulmonary complications?
Eligible children aged 6 to 18 years will be randomly assigned to one of three groups:
Coughing exercises group Incentive spirometry group Standard care group Children in the intervention groups will perform the assigned exercises every 3 hours for the first 3 days after surgery. All participants will receive daily monitoring, including vital signs, oxygen saturation, lung function assessment, and observation of postoperative recovery indicators such as feeding tolerance and mobility.
The study will assess primary outcomes such as postoperative respiratory function using a standardized respiratory score, and secondary outcomes including postoperative recovery indicators (quality of recovery scores), incidence of pulmonary complications, and length of stay in the pediatric intensive care unit (ICU).
This research will help identify the most effective method for improving respiratory outcomes, reducing complications, and supporting faster recovery in children after cardiac surgery.
Interventions
- Behavioral Coughing Exercises
participants will receive structured postoperative coughing exercises supervised by trained healthcare professionals. The intervention includes instruction on effective deep breathing followed by directed coughing to enhance airway clearance and prevent secretion retention. Exercises will be performed every 3 hours for three consecutive days after cardiac surgery, in addition to standard postoperative care. - Device Incentive Spirometry
participants will perform postoperative incentive spirometry using a standard incentive spirometer under professional supervision. Children will be instructed to perform slow, deep inspirations with visual feedback to promote lung expansion and alveolar recruitment. The intervention will be conducted 15 times every 3 hours for three days after surgery, alongside standard postoperative care. - Other Standard Postoperative Care
Participants will receive routine postoperative care according to institutional protocols following cardiac surgery. This includes standard medical and nursing management such as oxygen therapy, pain control, monitoring of vital signs, and mobilization as tolerated, without additional structured respiratory physiotherapy interventions.
Primary outcome measures
- Respiratory Function Score. [Time frame: Baseline, 1 hour after intervention, 3 hours, 6 hours, 24 hours, 48 hours, and 72 hours.]
Secondary outcome measures (4)
- Postoperative Recovery Indicators Assessed by Clinical and Functional Parameters [Time frame: Baseline, postoperative day 1, and postoperative day 7]
- Length of Intensive Care Unit (ICU) Stay [Time frame: From ICU admission after surgery until ICU discharge, up to postoperative day 14]
- Arterial Blood Gas (ABG) Parameters [Time frame: Baseline (prior to intervention) and 24, and 48 hours after intervention]
- postoperative complications [Time frame: From the first postoperative day until hospital discharge (up to 7 postoperative days).]
Eligibility criteria
Inclusion Crit
- Children aged 6 to 18 years scheduled for elective cardiac surgery.
- Postoperative extubation within 24 hours and judged clinically stable to begin respiratory therapy.
- Hemodynamically stable.
Exclusion criteria
- Pre-existing moderate-to-severe chronic lung disease requiring baseline oxygen therapy.
- Neuromuscular disorders significantly impairing cough/inspiratory effort.
- Emergency surgery, ongoing major bleeding.
- Prolonged mechanical ventilation >72 hours or tracheostomy on admission.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Triple blind
- Primary purpose
- Treatment
Study locations
Iraq · 4 centers
- Ibn Al-Bitar Specialized Hospital for Cardiac Surgery — Baghdad
- Ibn Al-Nafis Hospital for Cardiac, Thoracic and Vascular Surgery — Baghdad
- Iraqi Center for Heart Diseases — Baghdad
- Imam Al-Hassan Al-Mujtaba Hospital — Karbala
Identifiers
NCT: NCT07405333 · UOB-NUR-2026-01