Effect of Coughing Exercises Versus Incentive Spirometry on Respiratory Function and Recovery in Children After Cardiac Surgery.

Официальное название

Effect of Coughing Exercises Versus Incentive Spirometry on Respiratory Outcomes and Postoperative Recovery Among Children Undergoing Cardiac Surgery.

Обзор

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.

Подробное описание

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.

Вмешательства

• Поведенческое 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.
• Устройство 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.
• Другое 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.

Первичные конечные точки

• Respiratory Function Score. [Срок оценки: Baseline, 1 hour after intervention, 3 hours, 6 hours, 24 hours, 48 hours, and 72 hours.]

Вторичные конечные точки (4)

• Postoperative Recovery Indicators Assessed by Clinical and Functional Parameters [Срок оценки: Baseline, postoperative day 1, and postoperative day 7]
• Length of Intensive Care Unit (ICU) Stay [Срок оценки: From ICU admission after surgery until ICU discharge, up to postoperative day 14]
• Arterial Blood Gas (ABG) Parameters [Срок оценки: Baseline (prior to intervention) and 24, and 48 hours after intervention]
• postoperative complications [Срок оценки: From the first postoperative day until hospital discharge (up to 7 postoperative days).]

Критерии участия

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.

Критерии исключения

• 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.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Тройное слепое

Основная цель

Лечение

Центры проведения

Ирак · 4 центра

• 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

Идентификаторы

NCT: NCT07405333 · UOB-NUR-2026-01

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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