Deep Breathing Exercises and Incentive Spirometry After Rib Fracture

NCT ID: NCT06853002

Last Updated: 2025-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-15

Study Completion Date

2025-10-01

Brief Summary

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Chest trauma patients constitute approximately 10-15% of all traffic accidents. Many complications may occur after chest trauma, including rib fracture, pneumothorax, hemothorax, lung contusion, flail chest, atelectasis, respiratory failure and even death. Atelectasis is the most common of these complications. This study planned to investigate the effects of spirometry and deep breathing exercises on oxygenation after rib fracture.

Detailed Description

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Chest trauma is the second leading cause of death in traffic accidents, accounting for approximately 25% of deaths, only slightly lower than deaths from head injuries. Chest trauma can involve various organs, including the heart, great vessels, lungs, trachea, and esophagus or chest wall. Complications of rib fractures can follow, including pneumothorax, hemothorax, pulmonary contusion, flail chest, atelectasis, respiratory failure, and even death. Atelectasis is the most common complication. Patients with rib fractures usually do not require surgical intervention. However, hospitalization for pain control and further observation is necessary to maintain lung hygiene and prevent further complications. Patients with rib fractures usually complain of chest pain due to impaired lung hygiene, obstruction of the lower airway, and subsequent atelectasis and hypoventilation. Hypoxemia, pneumonia, respiratory failure, and other morbidities can lead to prolonged hospital stays and mortality.

spirometry exercise and deep breathing exercises are breathing exercises that help expand the lungs. They are often used to prevent postoperative lung atelectasis and reduce pulmonary complications after cardiac, lung, or abdominal surgery. They can increase maximum inspiratory capacity and lung compliance, improve oxygenation, and maintain lower airway patency to prevent and treat atelectasis.

Patients admitted to the intensive care unit due to rib fractures will be randomized into two groups according to the closed envelope drawing method. (Group S: spirometry group, Group D: deep breathing exercise group). Patients over the age of 18 who developed rib fractures due to thoracic trauma will be included in the study. Demographic characteristics, trauma score, systemic diseases, presence of lung contusion, number of rib fractures, additional trauma status laboratory values of the patients will be recorded.

The pain level of the patients will be monitored with Numeric rating scale (NRS) and the target will be NRS:0-2. The analgesia regimen will be recorded for this purpose.

Group S: Spirometry exercises will be performed in a sitting position by holding the device, exhaling normally and then closing the lips tightly around the mouthpiece. Then, the patient will perform maximum inspiration by taking long, deep and slow breaths. When the patient takes a deep breath, the balls in the chamber rise, after maximum inhalation, the patient will be asked to hold their breath for 3-5 seconds, then remove the mouthpiece and exhale slowly. spirometry exercises will be prescribed daily for follow-up in the intensive care unit, five times a day, ten repetitions each, with 1-2 hours of rest between exercises.

Group D: The patient will be asked to sit in a comfortable position with their hands on their lap, press the tip of their tongue to the tissue behind their upper front teeth and hold it there throughout the breathing cycle. After three normal breaths, they will take a deep breath through the nose for 4 counts, hold their breath for 7 counts, and then exhale slowly through the mouth for 8 counts and repeat the breathing cycle. This cycle will be applied five times a day, ten repetitions, during the follow-up in the intensive care unit.

The effect of these practices on oxygenation will be evaluated according to saturation and routine blood gas results.

In this study, the effects of spirometry and deep breathing exercises on oxygenation after rib fracture will be investigated as the primary objective, and the effects of spirometry and deep breathing exercises on the duration of intensive care stay will be investigated as the secondary objective.

Conditions

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Rib Fractures Oxygenation

Keywords

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Rib Fractures Breathing exercises Postoperative complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Group S

Spirometer group

Group Type ACTIVE_COMPARATOR

Breathing exercise with spirometry

Intervention Type OTHER

Breathing exercise with spirometry

Group D

Deep breathing exercise group

Group Type ACTIVE_COMPARATOR

Breathing exercise with deep breathing method

Intervention Type OTHER

Breathing exercise with deep breathing method

Interventions

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Breathing exercise with spirometry

Breathing exercise with spirometry

Intervention Type OTHER

Breathing exercise with deep breathing method

Breathing exercise with deep breathing method

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients who developed rib fractures due to thoracic trauma

Exclusion Criteria

* Patients who are unconscious
* Patients with a history of chronic obstructive pulmonary disease or asthma
* Patients with an Injury Severity Score (ISS) ≥ 16
* Patients who require mechanical ventilation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Samsun University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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özgür kömürcü

Role: STUDY_DIRECTOR

Samsun University

Locations

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Samsun University

Samsun, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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özgür kömürcü

Role: CONTACT

Phone: 90 5055273180

Email: [email protected]

Facility Contacts

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özgür kömürcü, 1

Role: primary

References

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Renault JA, Costa-Val R, Rosseti MB, Houri Neto M. Comparison between deep breathing exercises and incentive spirometry after CABG surgery. Rev Bras Cir Cardiovasc. 2009 Apr-Jun;24(2):165-72. doi: 10.1590/s0102-76382009000200012.

Reference Type BACKGROUND
PMID: 19768295 (View on PubMed)

Witt CE, Bulger EM. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma Surg Acute Care Open. 2017 Jan 5;2(1):e000064. doi: 10.1136/tsaco-2016-000064. eCollection 2017.

Reference Type BACKGROUND
PMID: 29766081 (View on PubMed)

Hu L, Hua Y, Wang L, Mao Z, Jia X, Lei Z, Chang D, Cheng W. Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial. J Perianesth Nurs. 2025 Feb;40(1):69-75. doi: 10.1016/j.jopan.2024.03.009. Epub 2024 Jul 9.

Reference Type BACKGROUND
PMID: 38980240 (View on PubMed)

Other Identifiers

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GOKAEK 2025/2/2

Identifier Type: -

Identifier Source: org_study_id