Effect of Active Cycle of Breathing Technique as Add on to Routine Chest Physical Therapy on Respiratory Parameters in Coronary Artery Bypass Graft Patients

NCT ID: NCT06705556

Last Updated: 2024-11-26

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 72 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-03-01
• Study Completion Date: 2024-12-20

Brief Summary

A controlled trial was conducted to determine the effect of the active cycle of breathing technique (ACBT) in improving respiratory parameters after coronary artery bypass graft surgery. The main aim of this study was to determine the effects of pre and postoperative active cycle of breathing technique (ACBT) in coronary artery disease patients undergoing coronary artery bypass graft surgery in improving respiratory parameters such as arterial blood gas (ABG), oxygen saturation (SpO2) and respiratory rate. The intervention group performed an active cycle of breathing technique with routine chest physical therapy while the control group performed routine chest physical therapy. Arterial blood gas (ABG), oxygen saturation (SpO2), and respiratory rate were measured at baseline and five days after surgery, every 2 hours on postoperative days 1, 2, and 3 and 4 hours on days 4 and 5.

Participants in the intervention group performed preoperative routine chest physical therapy sessions were followed as:

• Incentive spirometry, 3 sessions per day, 10 repetitions
• Percussions, 3 sessions per day, 20 repetitions
• 3-minutes walking, 2 sessions per day
• ACBT, 3 sessions per day

The preoperative chest physiotherapy treatment plan was continued after CABG surgery. In addition to these, the following were included postoperatively:

• Nebulization, 3 sessions per day
• 3 minutes of walking, 2 sessions per day
• ACBT, 3 sessions per day While participants in the control group performed the same pre and postoperative sessions except ACBT.

Detailed Description

This single-blinded randomized controlled trial was conducted at the Faisalabad Institute of Cardiology, Faisalabad, Pakistan, to assess the effects the Active Cycle of Breathing Technique (ACBT) as add on to routine chest physical therapy in the preoperative care of coronary artery bypass graft (CABG) patients. The primary aim was to evaluate ACBT's impact on minimizing postoperative respiratory complications. A secondary aim was to educate patients in the preoperative period to reduce surgery-related stress and support respiratory drive.

Patients with coronary artery disease are generally advised bed rest to manage shortness of breath. However, CABG is an invasive procedure that involves the placement of an endotracheal tube, raising infection risks and leading to weakened respiratory muscles due to ventilation effects. Post-surgery, patients often experience reduced lung volumes and altered arterial blood gases. Adding ACBT to chest physical therapy in the preoperative period is intended to improve ventilation and arterial blood gas levels postoperatively.

The study involved 72 male and female patients, aged 30 to 65, with double or triple-vessel coronary disease and a 10 to 15-year disease history, scheduled for CABG. Screening was performed using a custom questionnaire based on inclusion and exclusion criteria, and non-probability purposive sampling was used to select participants. Patients were randomly assigned to either the intervention or control group using the lottery method. The intervention group received ACBT alongside routine chest physical therapy, while the control group received only standard chest physical therapy, both pre- and postoperatively. Patient confidentiality was maintained through informed consent.

Key study parameters included arterial blood gas (ABG) levels, oxygen saturation (SpO2), and respiratory rate, with ABG samples taken from the brachial and radial arteries and analyzed via an ABG analyzer. SpO2 was measured using a pulse oximeter, and respiratory rate was recorded on a cardiac monitor.

Conditions

Coronary Artery Bypass Graft

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: SINGLE

Study Groups

The intervention group

The intervention group:

The intervention group (n=36) was instructed to perform the ACBT with routine chest physical therapy pre and postoperatively. The preoperative chest physical therapy was conducted 3 days before surgery and the postoperative CPT, including ACBT, was performed 3 times in the ICU for up to 5 days after surgery.

Preoperative routine chest physical therapy sessions were followed as:

• Incentive spirometer, 3 sessions per day, 10 repetitions
• Percussions, 3 sessions per day, 20 repetitions
• 3-minutes walking, 2 sessions per day
• ACBT, 3 sessions per day

The preoperative chest physiotherapy treatment plan was continued after CABG surgery. In addition to these, the following were included postoperatively:

• Nebulization, 3 sessions per day
• 3 minutes of walking, 2 sessions per day
• ACBT, 3 sessions per day

Group Type: EXPERIMENTAL

Active cycle of breathing technique, incentive spirometer, percussion, 3-minute of walking

Intervention Type: PROCEDURE

The intervention group:

patients were asked to perform Active cycle of breathing technique as add on to routine chest physical therapy such as Incentive spirometer, percussion, 3-minute of walking 3 days before surgery and five days postoperative.

• Incentive spirometry, 3 sessions per day, 10 repetitions
• Percussions, 3 sessions per day, 20 repetitions
• 3-minutes walking, 2 sessions per day
• ACBT, 3 sessions per day the following were included postoperatively:
• Nebulization, 3 sessions per day
• ACBT, 3 sessions per day

The control group

The control group:

The routine Chest physical therapy was performed 3 days before surgery at the preoperative bay and 5 days after surgery in the ICU with 3 sessions each day.

Preoperative chest physical therapy sessions were followed as:

• Incentive spirometer, 3 sessions per day, 10 repetitions.
• Percussions, 3 sessions per day, 20 repetitions.
• 3-minutes walking, 2 sessions per day The preoperative chest physiotherapy treatment plan was continued after CABG surgery. In addition to these, the following were included postoperatively:
• Nebulization, 3 sessions per day
• 3-minutes walking, 2 sessions per day

Group Type: EXPERIMENTAL

incentive spirometer, percussion, 3-minute of walking

Intervention Type: PROCEDURE

The control group The routine CPT was performed 3 days before surgery at the preoperative bay and 5 days after surgery in the ICU with 3 sessions each day.

Preoperative chest physical therapy sessions were followed as:

• Incentive spirometry, 3 sessions per day, 10 repetitions.
• Percussions, 3 sessions per day, 20 repetitions.
• 3-minutes walking, 2 sessions per day The preoperative chest physiotherapy treatment plan was continued after CABG surgery. In addition to these, the following were included postoperatively:
• Nebulization, 3 sessions per day
• 3-minutes walking, 2 sessions per day

Interventions

Active cycle of breathing technique, incentive spirometer, percussion, 3-minute of walking

The intervention group:

patients were asked to perform Active cycle of breathing technique as add on to routine chest physical therapy such as Incentive spirometer, percussion, 3-minute of walking 3 days before surgery and five days postoperative.

• Incentive spirometry, 3 sessions per day, 10 repetitions
• Percussions, 3 sessions per day, 20 repetitions
• 3-minutes walking, 2 sessions per day
• ACBT, 3 sessions per day the following were included postoperatively:
• Nebulization, 3 sessions per day
• ACBT, 3 sessions per day

Intervention Type: PROCEDURE

incentive spirometer, percussion, 3-minute of walking

The control group The routine CPT was performed 3 days before surgery at the preoperative bay and 5 days after surgery in the ICU with 3 sessions each day.

Preoperative chest physical therapy sessions were followed as:

• Incentive spirometry, 3 sessions per day, 10 repetitions.
• Percussions, 3 sessions per day, 20 repetitions.
• 3-minutes walking, 2 sessions per day The preoperative chest physiotherapy treatment plan was continued after CABG surgery. In addition to these, the following were included postoperatively:
• Nebulization, 3 sessions per day
• 3-minutes walking, 2 sessions per day

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Elective coronary artery bypass graft patients
• The study included both male and female
• 30 to 65 years old patients were included in this study
• Adults with stable coronary artery disease for the last 15 years

Exclusion Criteria

• Patient with unstable vitals
• Preoperative pulmonary dysfunction
• COPD or Emphysema
• Asthma and Severe atelectasis
• Renal disorders
• Connected to the ventilator for more than 48 hours

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Sadaf Bukhari

OTHER

Sponsor Role: lead

Responsible Party

Sadaf Bukhari

Principal investigator

Responsibility Role: SPONSOR_INVESTIGATOR

Locations

The University of Faisalabad

Faisalabad, Punjab Province, Pakistan

Dr Sana Ashraf

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

Tuf/IRB/292/24

Identifier Type: -

Identifier Source: org_study_id