Effect of Different Breathing Techniques on Dyspnea and Cardiopulmonary Parameters Among Patients After Open Heart Surgery

Официальное название

Effect of Segmental Breathing Versus Active Cycle Breathing Techniques on Dyspnea and Cardiopulmonary Parameters Among Patients After Open Heart Surgery: Randomized Controlled Trial.

Обзор

Open heart surgery is often associated with postoperative pulmonary complications, reduced lung expansion, dyspnea, and impaired cardiopulmonary function. Breathing exercises are commonly used after surgery to improve lung ventilation, enhance oxygenation, and support respiratory recovery. However, limited evidence is available comparing the effectiveness of segmental breathing exercises and active cycle breathing technique (ACBT) in patients after open heart surgery. This randomized controlled trial will compare the effects of segmental breathing exercises and ACBT on dyspnea and cardiopulmonary parameters in adults undergoing open heart surgery. Participants will be randomly assigned to either the segmental breathing exercise group, the ACBT group, or the standard care group during the postoperative period following extubation. Cardiopulmonary parameters, including oxygen saturation, respiratory rate, heart rate, and blood pressure, as well as dyspnea severity and postoperative pulmonary complications, will be assessed before and after the interventions. The findings of this study may help identify the most effective breathing exercise technique for improving respiratory outcomes, reducing postoperative pulmonary complications, and supporting evidence-based postoperative rehabilitation after cardiac surgery.

Подробное описание

This randomized clinical trial evaluates the effects of segmental breathing exercises (SBE) and active cycle breathing technique (ACBT) on dyspnea, cardiopulmonary parameters, and postoperative pulmonary complications in adults undergoing elective open-heart surgery with cardiopulmonary bypass.

Participants will be randomly assigned to one of three groups: segmental breathing exercises group, active cycle breathing technique group, or standard care group. Patients in the intervention groups will perform the assigned breathing exercises after extubation, including sessions conducted 1 hour and 6 hours post-intervention during the early postoperative period.

Cardiopulmonary parameters, including oxygen saturation, respiratory rate, heart rate, and blood pressure parameters, will be monitored throughout hospitalization. Dyspnea and postoperative pulmonary complications, including atelectasis and pneumonia, will also be assessed.

The primary purpose of this study is to determine the effectiveness of breathing exercise interventions in improving postoperative respiratory outcomes and reducing pulmonary complications after cardiac surgery. The study also aims to support evidence-based postoperative rehabilitation practices for healthcare professionals caring for patients after open-heart surgery.

Вмешательства

• Поведенческое Segmental Breathing Exercises
  Deep breathing exercises focusing on specific lung segments to improve ventilation, lung expansion, and oxygenation in post open heart surgery patients.
• Поведенческое Active Cycle Breathing Technique
  A combination of breathing control, thoracic expansion exercises, and forced expiration technique to improve airway clearance and lung function.
• 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

• Oxygen Saturation (SpO₂) [Срок оценки: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay]
• Respiratory Rate [Срок оценки: Measurements will be obtained at baseline pre-intervention,1 hour post-intervention, and 6 hours post-intervention]
• Heart Rate [Срок оценки: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay]
• Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure [Срок оценки: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay]

Вторичные конечные точки (1)

• Dyspnea Index [Срок оценки: measur at baseline pre-intervention and post-intervention after 6 hours.]

Критерии участия

Критерии включения

• Age 18-75 years.
• Scheduled for elective open-heart surgery.
• Can understand instructions and perform Segmental breathing and Active cycle breathing techniques.
• Stable preoperative hemodynamic condition.

Критерии исключения

• Emergency cardiac surgeries.
• Patients with pre-existing severe pulmonary disease (e.g., COPD, asthma, restrictive lung disease, Atelectasis, and Tuberculosis).
• Neurological disorders affecting breathing effort.
• Patients with rib fractures, recent thoracic trauma, or contraindications for coughing maneuvers.
• Inability to provide informed consent (cognitive impairment, language barrier).

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

Простое слепое

Основная цель

Лечение

Центры проведения

Ирак · 3 центра

• Ibn Al-Bitar Specialized Hospital for Cardiac Surgery — Baghdad
• Iraqi Center for Heart Diseases — Baghdad
• Al-Hassan Al-Mujtaba Hospital — Karbala

Публикации

• Salehi Derakhtanjani A, Ansari Jaberi A, Haydari S, Negahban Bonabi T. Comparison the Effect of Active Cyclic Breathing Technique and Routine Chest Physiotherapy on Pain and Respiratory Parameters After Coronary Artery Graft Surgery: A Randomized Clinical Trial. Anesth Pain Med. 2019 Oct 16;9(5):e94654. doi: 10.5812/aapm.94654. eCollection 2019 Oct. PMID 31903332

Идентификаторы

NCT: NCT07591987 · UOB-NUR-2026-03

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗