Respiratory Muscle Training in Patients Recovering Recent Open Cardiothoracic Surgery: A Randomized-Controlled Trial

Abstract

Objectives. To evaluate the clinical efficacy and feasibility of an expiratory muscle training (EMT) device (Respilift) applied to patients recovering from recent open cardiothoracic surgery (CTS). Design. Prospective, double-blind, 14-day randomised-controlled trial. Participants and Setting. A total of 60 inpatients recovering from recent CTS and early admitted to a pulmonary rehabilitation program. Interventions. Chest physiotherapy plus EMT with a resistive load of 30 cm H2O for active group and chest physiotherapy plus EMT with a sham load for control group. Measures. Changes in maximal expiratory pressure (MEP) were considered as primary outcome, while maximal inspiratory pressures (MIP), dynamic and static lung volumes, oxygenation, perceived symptoms of dyspnoea, thoracic pain, and well being (evaluated by visual analogic scale—VAS) and general health status were considered secondary outcomes. Results. All outcomes recorded showed significant improvements in both groups; however, the change of MEP (+34.2 mmHg, P < 0.001 and +26.1%, P < 0.001 for absolute and % of predicted, resp.) was significantly higher in active group. Also VAS dyspnoea improved faster and more significantly (P < 0.05) at day 12, and 14 in active group when compared with control. The drop-out rate was 6%, without differences between groups. Conclusions. In patients recovering from recent CTS, specific EMT by Respilift is feasible and effective. This trial is registered with ClinicalTrials.gov NCT01510275.

Effect of Inspiratory Muscle Training on Clinical Outcomes of Patients Undergoing Cardiothoracic Surgeries

“…This finding was in agreement with by Crisafulli et.al, (2013) (60) and Valkenet et.al, (2013) (61) who found that the majority of studied groups had coronary artery bypass graft surgery and valve surgery. Also, Kodric et.al, (2013) (56) reported that the majority of the studied groups underwent coronary artery bypass graft surgery.…”

“…Moreover, the findings of the current study were supported by Kodric et.al, (2013) (56) whoconcluded that training of inspiratory muscles has a positive effect on dyspnea and activities of daily living. Crisafulli et.al, (2013) (60) observed that dyspnea improved faster and more significantly in the study when compared with control group. In contrast, Jeong et.al, (2015) (75) found that dyspnea was reduced in the study group but this reduction was not statistically significant.…”

Comparisons and correlations of pain intensity and respiratory and peripheral muscle strength in the pre- and postoperative periods of cardiac surgery

“…In an evaluation of the clinical efficacy and feasibility of a respiratory muscular training device applied to patients after cardiothoracic surgery, Crisafulli et al. (24) observed improvement in both IP max and EP max 14 days after surgical procedures associated with the use of the device. While IP max refers mainly to the force of the diaphragm, EP max mainly reflects the strength of the abdominal and intercostal muscles.…”

Permanence of Lung Disorders after Hospital Discharge of Patients Who Underwent Cardiac Surgery: An Integrative Review

“…The reduction in lung volumes and capacities contributes to changes in gas exchange, resulting in hypoxemia and decreased diffusion capacity [13] [14]. Atelectasis, pleural effusion, and pneumonia are pulmonary complications frequently found [12] [16] [17]. However, other complications such as hypercapnia, reintubation, and respiratory failure are also observed [14].…”