Coronary Artery Bypass Graft Surgery Clinical Trial
Official title:
Effects of Active Cycle of Breathing Technique on Pulmonary Functions After CABG During Phase 1 Cardiac Rehabilitation
This study is designed to determine the effects of Active cycle of breathing technique (ACBT) on cardiopulmonary parameters of post CABG patients. A randomized control trial was conducted with a sample size of 40 post CABG patients. Non probability Convenience Sampling Technique was used to collect sample and randomization was done through sealed envelope method to allocate participants to the groups. Patients in experimental group did ACBT along with the conventional treatment protocol that was performed in the control group. Subjects completed the exercise protocol of 5 days. Both male and female post CABG patients of age 30-65 years who were vitally stable were included in study. Data was analyzed on Statistical Package for the Social Sciences (SPSS) version 21. Normality was assessed through shapiro wilk test. Parametric tests were applied on normally distributed variables and non parametric tests were applied for the non normally distributed data. Confidence interval was kept at 95% and p value <0.05 was considered significant.
Coronary artery bypass graft (CABG) is a surgery in which new routes are created around
narrow and blocked coronary arteries, that allow proper flow of blood to provide oxygen and
nutrients to the heart muscles. The grafts used in CABG can be a vein from lower extremity or
any artery of chest. CABG is a surgery in which obstructed coronary arteries are replaced
with autologous arteries and veins used as implant, which are fully or moderately congested
by atherosclerotic plaque. ACBT is a method used to clear out the secretion from the chest.
The purpose of ACBT treatment is to remove secretions from the chest that helps to reduce the
frequency of infection, which control the additional airway impairment and worsening the
lungs functions that may help in reducing the rate of progress of lung disease. After CABG
surgery respiratory therapy is used rationally to inhibit the post-operative complications.
Respiratory physiotherapy is routinely used in the prevention and treatment of post-operative
pulmonary complications after cardiac surgery. The ultimate goal of physiotherapy in CABG
patient is to improve increase lung volume, prevent atelectasis, enhance
ventilation-perfusion matching, to increase sputum clearance, and decrease pain. ACBT
technique can perform independently by patient with about applying manual technique. ACBT is
very effective to improve oxygen saturation, control respiratory rate, and chest clearance
after major surgeries. The efficiency of ACBT treatment has been checked out in stable cystic
fibrosis, Chronic obstructive pulmonary disease and abdominal surgery. However, there is
limited literature related to its use in patients after CABG surgery. The purpose of this
research was to examine the effect of ACBT versus conventional chest physiotherapy after CABG
surgery.
In 2018 a study was conducted on effect of ACBTs in post coronary artery bypass grafting
patient and he concluded that ACBTs technique is a better way of treatment in coronary artery
bypass grafting surgery patients. The determination of this research was to calculate the
effectiveness of ACBT in CABG surgery patients. In this study total 15 patients were
involved. All the patients were checked out by visual analogue scale for pain, 6-minute walk
test (6MWT) for endurance and chest expansion was also measured. It concluded that chest
expansion and 6MWT was improved in both groups.
ACBT is an effective technique implemented by the patient to secrete out the sputum from the
main airway. The ACBT technique is combined breathing maneuvers to advance the efficiency of
cough, untie and clear the secretions and increase the ventilation.
In 2016 a study was conducted observed the effects of ACBTs in post CABG surgery patients and
The ACBTs treatment decrease the intensity of pulmonary impairments in post abdominal
surgery.There is limited data available in support of effects of ACBTs on pulmonary functions
after CABG surgery.
In 2015 a study was conducted to evaluate the effects of ACBTs on chest expansion, arterial
blood gases, oxygen saturation, blood pressure, respiratory rate and other vitals in Chronic
Obstructive Pulmonary disease (COPD) patients during 1st phase of cardiac rehab after CABG
surgery. It concluded that ACBT are much effective than routine physiotherapy protocol in
patients who have gone under coronary artery bypass grafting.
The present study is intended to observe the effects of ACBT on pulmonary function including
lung volumes and capacities, chest expansion as well as the vitals of post operative CABG
patients undergoing phase 1 cardiac rehabilitation.
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