The effect of incentive spirometry on arterial blood gases after coronary artery bypass surgery (CABG)

Ahmadreza Yazdannik, Hiva Mohammadi Bollbanabad, Mohsen Mirmohammadsadeghi, Asghar Khalifehzadeh

Abstract


Background: After coronary artery bypass surgery, pulmonary complications and oxygenation disorders are common, which have an important role in mortality and morbidity. Different methods are used for the improvement of pulmonary function and oxygenation, of which incentive spirometry (IS) has been investigated here. The aim of this study is to evaluate the effects of IS on arterial blood gases after coronary artery bypass graft (CABG).

Materials and Methods: This was a clinical trial. Fifty patients who were candidates for CABG were chosen. The patients had been allocated to two random groups of intervention and control. The intervention was done through IS. These two groups were compared for the arterial blood gases’ preoperative level, and the levels on first (after extubation), second, and third postoperative days.

Results: The study findings showed that on the third postoperative day, there was a significant difference between the intervention and control groups in the mean amount of arterial blood oxygen (82.3 ± 4.7 vs. 72.7 ± 7.1, respectively, P = 0.02), arterial blood carbon dioxide (36.8 ± 2 vs. 43.7 ± 3.2, respectively, P = 0.007), and oxygen saturation (96.8 ± 1.4 vs. 90.5 ± 1.4, respectively, P = 0.03).

Conclusions: This investigation shows that using IS is significantly effective in the improvement of blood arterial gas parameters.

 


Keywords


Arterial blood gasses; coronary artery bypass surgery; incentive spirometry

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References


Keenan TD, Abu‑Omar Y, Taggart DP. Bypassing the pump: Changing practices in coronary artery surgery. Chest 2005;128:363‑9.

Pasquina P, Tramèr MR, Walder B. Prophylactic respiratory physiotherapy after cardiac surgery: Systematic review. BMJ 2003;327:1379.

Mullen‑Fortino M, O’Brien N, Jones M. Critical care of a patient after CABG surgery. Nurs 2011 Critical Care 2009;4:46.

Wynne R, Botti M. Postoperative pulmonary dysfunction in adults after cardiac surgery with cardiopulmonary bypass: Clinical significance and implications for practice. Am J Crit Care 2004;13:384‑93.

Zarbock A, Mueller E, Netzer S, Gabriel A, Feindt P, Kindgen‑Milles D. Prophylactic nasal continuous positive airway pressure following cardiac surgery protects from postoperative pulmonary complicationsa prospective, randomized, controlled trial in 500 patients. Chest 2009;135:1252‑9.

Westerdahl E, Lindmark B, Eriksson T, Friberg O, Hedenstierna Gr, Tenling A. Deep‑breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest 2005;128:3482‑8.

Margereson C, Riley J. Postoperative care following cardiothoracic surgery. Cardiothoracic surgical nursing trends n adult nursing. 2003:129‑204.

Brunner S, Suddarth S. Text book of medical surgical nursing. Amsterdam: Elsevier; 2008.

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;24:165‑72.

Carvalho CR, Paisani DM, Lunardi AC. Incentive spirometry in major surgeries: A systematic review. Rev Bras Fisioter 2011;15:343‑50.

Overend TJ, Anderson CM, Lucy SD, Bhatia C, Jonsson BI, Timmermans C. The effect of incentive spirometry on postoperative pulmonary complications a systematic review. Chest 2001;120:71‑98

Afrasiabi A, Hasanzadeh S, Negargar S, Ghafari MR, Ansarin K. The effect of incentive spirometry on pulmonary volumes and arterial blood gases after coronary artery bypass surgery. J Kermanshah Univ Med Sci 2007;10:1.

Agostini P, Singh S. Incentive spirometry following thoracic surgery: What should we be doing? Physiotherapy 2009;95:76‑82.

Craven RF, Hirnle CJ. Fundamentals of nursing: Human health and function. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2003. p. 820.

Hardin S, Kaplow R. Cardiac surgery essentials for critical care nursing. United States: Jones and Bartleftt Publication; 2010. p 149.

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;24:165‑72.

Rafea A, Wagih KH, Amin H, El‑Sabagh R, Yousef S. Flow_ oriented incentive spirometry versus volume spirometry taraining on pulmonary ventilation after abdominal surgery. Egypt J Bronchol 2009; 3:18‑110.

Hough A. Physiotherapy in respiratory care: An evidence‑based approach to respiratory and cardiac management. United Kingdom: Nelson Thornes; 2001.

Moradyan S, Farahani M, Mohammadi N, Jamshidi R. The effect of planned breathing exercises on oxygenation in patients after coronary artery bypass surgery. Cardiovasc Nurs J Spring 2012;1:8-14.

Brage I, Fernandez S, Stein A, Gonzalez U, Diaz S, Garcia A. Respiratory phsiotherapy and incidennce of pulmonary complication in off‑pump coronary artery bypass graf surgery: An observational follow‑up study. BMC Pulm Med 2009;9:466‑9.


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