Dyspnea, Cardiopulmonary Dysfunction, Postoperative Respiratory Dysfunction, Coronary Artery Disease
Conditions
Keywords
Open Heart Surgery, Cardiac Surgery, Breathing Exercises, Segmental Breathing Exercises, Active Cycle Breathing Technique, Postoperative Patients, Adult Patients, Dyspnea, Cardiopulmonary Parameters
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALActive Cycle Breathing Technique
A combination of breathing control, thoracic expansion exercises, and forced expiration technique to improve airway clearance and lung function.
BEHAVIORALSegmental Breathing Exercises
Deep breathing exercises focusing on specific lung segments to improve ventilation, lung expansion, and oxygenation in post open heart surgery patients.
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.
Sponsors
University of Baghdad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
participants will be randomly assigned into intervention groups receiving segmental breathing exercises and another receiving active cycle breathing techniques compare to control group after open heart surgery to evaluate their effects on dyspnea and cardiopulmonary parameters.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* 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.
Exclusion criteria
* 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).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxygen Saturation (SpO₂) | Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay | Assessment of peripheral oxygen saturation in patients after open heart surgery undergoing breathing exercises (segmental breathing exercises or active cycle breathing technique) |
| Respiratory Rate | Measurements will be obtained at baseline pre-intervention,1 hour post-intervention, and 6 hours post-intervention | Assessment of respiratory rate in patients after open heart surgery undergoing breathing exercises. |
| Heart Rate | Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay | Assessment of heart rate in patients after open heart surgery undergoing breathing exercises. |
| Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure | Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay | Assessment of Systolic Blood Pressure Pulse Pressure, and Diastolic Blood Pressure in patients after open heart surgery undergoing breathing exercises. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dyspnea Index | measur at baseline pre-intervention and post-intervention after 6 hours. | Assessment of dyspnea index in patients after open heart surgery using a standardized dyspnea scale contain ten questions for score 0 = Never. 1 = Almost never. 2 = Sometimes. 3 = Almost always. 4 = Always , the higher number is the worst that to evaluate changes before interventions and after implementation of segmental breathing exercises or active cycle breathing techniques. |
Countries
Iraq
Contacts
CONTACTMuslim Aqeel Essa, Master Student
CONTACTRusul Khalid Kadhim, Master Student
PRINCIPAL_INVESTIGATORWafaa Abd Ali Hattab, Assist prof
College of Nursing , University of Baghdad
Outcome results
None listed