Effect of Deep Breathing Exercises on Pulmonary Functions after Cardiac Surgery

Document Type : Original Article

Authors

1 Medical surgical nursing department, Faculty of nursing, Port Said University, Port Said city, Egypt.

2 Medical surgical nursing

3 medical surgical nursing -faculty of nursing- port saied university

Abstract

Background: Postoperative pulmonary complications (PPCs) are common after cardiac Surgery. They are a major contributor to morbidity, compromise oxygenation, extend hospitalization, and raise death. Aim: The present study aimed to evaluate the effect of deep breathing exercises on pulmonary functions after cardiac surgery. Subjects and Method: Design: A Quasi experimental design was used. Setting: The study conducted in intensive care units of cardiac surgery and surgical wards settings at Al-Nasr specialized hospital in Port Said Governorate and Damietta cardiac and gastrointestinal center in Damietta Governorate. Subjects: It included a purposive sample of 74 patients post-operative cardiac surgery. Tools: Four tools were used for data collection consisted of; medical and surgical history assessment in addition to patient sociodemographic characteristics, Pulmonary functions assessment, Melbourne Group Scale Version II, and Observational checklist for deep breathing exercises. The Results: There were statistically significant differences between pre and post applying deep breathing exercises regarding all pulmonary functions after cardiac surgery with P-Value of (<0.001). Conclusion: There was statistically significant relation between the studied patients’ BMI, education, and health habits and post patients` education regarding applying deep breathing exercises. Furthermore, there was statistically significant relation between deep breathing exercises and pulmonary functions after cardiac surgery. Recommendations: Further research is necessary to design and implement educational programs for critical units’ nurses regarding importance of applying deep breathing exercises for patients after cardiac surgery to enhance pulmonary functions and prevent pulmonary complications.

Keywords

Main Subjects

References

Abd-Elbaky, M. M., Mohammed, I. R., & Mobarak, Y.S. (2020). Pulmonary function status after implementing chest physiotherapy for extubated cardiothoracic surgery patients. Assiut Scientific Nursing Journal, 8(23), 144-152.
Abdelhafez, N. G. E., & Fouad, M. R. (2023). Effect of incentive spirometry on postoperative pulmonary complications and oxygenation following open heart surgery. Sohag Journal of Nursing Science, 2(3), 1-11.
Abd-Elmalek, S. E., Abdelaziz, M. A., Khalaf, G., S., &Taha, a. m. (2019). Assessment of nursing care on patient’s outcomes after minimally invasive and convential cardiac surgery. Assiut Scientific Nursing Journal, 7(19), 56-69.
Ahmed, M., Abbas Y., Mohammed M., (2019). Comparison the effect of conservative therapy and blow bottle among open heart surgery patients for the prevention of postoperative pulmonary complications. IOSR Journal of Nursing and Health Science, 4 (4), 42.
Amin, R., Alaparthi, G. K., Samuel, S. R., Bairapareddy, K. C., Raghavan, H., & Vaishali, K. (2021). Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Scientific Reports, 11(1), 6730.
Alaparthi, G. K., Amin, R., Gatty, A., Raghavan, H., Bairapareddy, K. C., Vaishali, K., ... & Hegazy, F. A. (2021). Contrasting effects of three breathing techniques on pulmonary function, functional capacity and daily life functional tasks in patients following valve replacement surgery-A pilot randomized clinical trial. Heliyon, 7(7).
Aquino, T. N. D., Prado, J. P., Crisafulli, E., Clini, E. M., & Galdino, G. (2024). Efficacy of Respiratory Muscle Training in the Immediate Postoperative Period of Cardiac Surgery: A Systematic Review and Meta-Analysis. Brazilian Journal of Cardiovascular Surgery, 39, e20220165.
Arrafi, A. R., Mirwanti, R., & Nuraeni, A. (2022). Case Study: Application Of Slow Deep Breathing Intervention In Post-CABG Coronary Artery Disease Patients With Acute Pain Nursing Problems. Padjadjaran Acute Care Nursing Journal, 3(2).
Azizi, H. R., babatabar Darzi, H., Azimi, A. V., Mahmoudi, H., & Saeed, Y. (2020). The effect of implementing nursing care package on the incidence of pulmonary atelectasis in patients after open heart surgery. Journal of Critical Care Nursing, 13(3), 48-54.‏
Boden, I., & Denehy, L. (2022). Respiratory prehabilitation for the prevention of postoperative pulmonary complications after major surgery. Current Anesthesiology Reports, 1-15.
Bulut, G., & Karabulut, N. (2023). The effects of breathing exercises on patients having laparoscopic cholecystectomy surgery. Clinical nursing research, 32(4), 805-814.
Chaudhary, S., Chaudhary, N. I., Ghewade, B., & Mahajan, G. (2020). The Immediate Effects of Breathing Exercises with Acapella and Incentive Spirometer on Preventing Early Pulmonary Complications Following Cabg.-A Comparitive Study. International Journal of Current Research and Review, 12(17), 51-58.‏
Cleveland Clinic. (2022). Coronary Artery Disease. Retrieved from my.cleveland: https://my.clevelandclinic.org/health/diseases/168 98-coronary-artery-disease.
Faul, F., Erdfelder, E., Lang, A.G., &Buchner, A. (2007). G8 Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavioral research methods, 39, 175-191.
Fatima, A., & Kazmi, S. (2021). Comparison of effects of incentive spirometry and deep breathing exercises on pulmonary functions after coronary artery bypass grafting. Khyber Medical University Journal, 13(3), 131-5.
Franklin, E., & Anjum, F. (2023). Incentive spirometer and inspiratory muscle training. In StatPearls [Internet]. StatPearls Publishing.
Ghorbani, A., Hajizadeh, F., Sheykhi, M. R., & Asl, A. M. P. (2019). The effects of deep-breathing exercises on postoperative sleep duration and quality in patients undergoing coronary artery bypass graft (CABG): a randomized clinical trial. Journal of caring sciences, 8(4), 219.
Girgin, Z., Ciğerci, Y., & Yaman, F. (2021). The effect of pulmonary rehabilitation on respiratory functions, and the quality of life, following coronary artery bypass grafting: a randomised controlled study. BioMed Research International, 2021(1), 6811373.
Jafari, H., Bagheri-Nesami, M., Khosravi, S., Habibi, M. R., & Tohamtan, R. A. M. (2023). The effect of breathing exercises on respiratory condition after coronary artery bypass surgery. Journal of Nursing and Midwifery Sciences, 10(3).
Joshi, N., & Singh, A. (2023). Comparative Study of Effect of Segmental Breathing Exercise and Deep Breathing Exercise in CABG Patients. International Journal of Health Sciences and Research, 13(7), 253-267.
Kinas, S. B., & Bilgic, S. (2024). Impact of breathing exercises in patients who had open heart operation on respiratory function and exercise tolerance. The Australian Journal of Advanced Nursing, 41(1), 10-20.
Kochupurackal, J. C., Bhattacharjee, S., Baidya, D. K., Panwar, R., Prakash, K., Rewari, V., & Maitra, S. (2024). Postoperative pulmonary complications with high versus standard FiO2 in adult patients undergoing major abdominal surgery: A noninferiority trial. Surgery, 175(2), 536-542.
Lagier, D., Zeng, C., Fernandez-Bustamante, A., & Vidal Melo, M. F. (2022). Perioperative pulmonary atelectasis: part II. Clinical implications. Anesthesiology, 136(1), 206-236.‏
Li, X., Chen, C., Wei, x., Zhu, Q., Yao, W., Yuan, D., … & Hei, Z. (2018). Retrospective comparative study on postoperative pulmonary complications after orthotopic liver transplantation using the Melbourne   group scale (MGS-2) diagnostic criteria. Annuals of transplantation, 23,377.
Lockstone, J., Boden, I., Robertson, I. K., Story, D., Denehy, L., & Parry, S. M. (2019). Non-Invasive Positive airway Pressure thErapy to Reduce Postoperative Lung complications following Upper abdominal Surgery (NIPPER PLUS): protocol for a single-centre, pilot, randomised controlled trial. BMJ open, 9(1), e023139.
Lugg, S. T., Agostini, P. J., Tikka, T., Kerr, A., Adam, K., Bishay, E., …& Naidu, b. (2016). Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax, 71(2), 171-176.
Mera, N., Wilches, L. E. C., & Benavides-Cordoba, V. (2024). Comparative analysis of pulmonary ventilation distribution between low-cost and branded incentive spirometers using electrical impedance tomography in healthy adults: Study protocol. Plos one, 19(5), e0302476.
Manapunsopee, S., Thanakiatpinyo, T., Wongkornrat, W., Chuaychoo, B., & Thirapatarapong, W. (2020). Effectiveness of incentive spirometry on inspiratory muscle strength after coronary artery bypass graft surgery. Heart, Lung and Circulation, 29(8), 1180-1186.‏
Moneruzzaman, M., Sun, W. Z., Changwe, G. J., & Wang, Y. H. (2023). Efficacy of Multiple Exercise Therapy after Coronary Artery Bypass Graft: A Systematic Review of Randomized Control Trials. Reviews in Cardiovascular Medicine, 24(5), 141.
Moradian, S. T., Heydari, A. A., & Mahmoudi, H. (2019). What is the role of preoperative breathing exercises in reducing postoperative atelectasis after CABG?. Reviews on recent clinical trials, 14(4), 275-279.
Oshvandi, K., Bostanbakhsh, A., Salavati, M. Moghimbeighi, A., & Maghsoudi, Z. (2020). Effect of- respiratory exercises on the prevalence of atelectasis in patients undergoingcoronary artery bypass surgery. Avicenna Journal of Midwifery care, 27(6), 432-440.
Overbeek, M. C., Reijneveld, E. A., Valkenet, K., van Adrichem, E. J., Dronkers, J. J., Ruurda, J. P., & Veenhof, C. (2024). The association between preoperative inspiratory muscle training variables and postoperative pulmonary complications in subjects with esophageal cancer. Respiratory Care, 69(3), 290-297.
Saliba, K. A., Blackstock, F., McCarren, B., & Tang, C. Y. (2022). Effect of positive expiratory pressure therapy on lung volumes and health outcomes in adults with chest trauma: a systematic review and meta-analysis. Physical therapy, 102(1), pzab254.‏
Shahid, N., Arwa, M., Arshad, Z., Niazi, R., Mehrvi, N., & Jamil, A. (2024). Effects of Deep Breathing Exercises on Old Versus Young Patients Undergoing Valve Replacement Surgery. Medical Forum Monthly, 35(4), 51-54.
Ureel, C., Emtner, M., Hedenstorm, H., & Westerdahl, E. (2016). Respiratory muscle strength is not decreased in patients undergoing cardiac surgery. Journal of cardiothoracic surgery, 11(1), 1-5.
Vitomskyi, V., Al-Hawamdeh, K., Lazarіeva, О., & Vitomskа, M. (2020). The efficacy of using Tri-Ball breathing exercises in respiratory function recovery of the patients undergoing cardiac surgery.
Wang, Y., Luo, Z., Huang, W., Zhang, X., Guo, Y., & Yu, P. (2023). Comparison of Tools for Postoperative Pulmonary Complications After Cardiac Surgery. Journal of cardiothoracic and vascular anesthesia, 37(8), 1442–1448. https://doi.org/10.1053/j.jvca.2023.03.031
Westerdahl, E., Lindmark, B., Eriksson, T., Hedenstierna, G., & Tenling, A. (2019). The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery. Scandinavian Cardiovascular Journal, 37(6), 363-367.
Wu, Q., Liu, L., Jiang, X., Hu, Y. Y., Liang, Q. S., He, Z. S., ... & Wang, X. H. (2020). Effect of voluntary breathing exercises on stable coronary artery disease in heart rate variability and rate-pressure product: a study protocol for a single-blind, prospective, randomized controlled trial. Trials, 21, 1-11.
Yazdannik, A., Bollbanabad, H. M., Mirmohammadsadeghi, M., & Khalifezade, A. (2016). The effect of incentive spirometry on arterial blood gases after coronary artery bypass surgery (CABG). Iranian journal of nursing and midwifery research, 21(1), 89-92.
Zerang, F., Amouzeshi, A., & Barkhordari-Sharifabad, M. (2022). Comparison of the effect of incentive spirometry and deep breathing exercises on hemodynamic parameters of patients undergoing coronary artery bypass graft surgery: A Clinical Trial. Journal of Vascular Nursing, 40(3), 134-139.
Sigona, A., & Richman, D. C. (2023). Identifying and reducing risks of postoperative pulmonary complications. Journal of Oral and Maxillofacial Anesthesia, 2. https://doi.org/10.21037/joma-23-20
Fischer, M. O., Brotons, F., Briant, A. R., Suehiro, K., Gozdzik, W., Sponholz, C., ... & VENICE Study Group. (2022). Postoperative pulmonary complications after cardiac surgery: the VENICE international cohort study. Journal of cardiothoracic and vascular anesthesia, 36(8), 2344-2351.
Mali, S., & Haghaninejad, H. (2019). Pulmonary complications following cardiac surgery. Archives of Medical Science-Atherosclerotic Diseases, 4(1), 280-285.
Hussein, E. E., & Taha, N. M. (2022). Effect of breathing exercises on quality of recovery among postoperative patients. International Journal of Studies in Nursing, 3(3), 151.
Kamarajah, S. K., Bundred, J., Weblin, J., & Tan, B. H. (2020). Critical appraisal on the impact of preoperative rehabilitation and outcomes after major abdominal and cardiothoracic surgery: a systematic review and meta-analysis. Surgery, 167(3), 540-549.
Urell, C., Emtner, M., Hedenstrom, H., & Westerdahl, E. (2016). Respiratory muscle strength is not decreased in patients undergoing cardiac surgery. Journal of cardiothoracic surgery, 11(1), 1-5.
Elkhayat, H., Elsayed, H. H., Adel, W., Elkhouly, A. G., Abdellateef, A., Moneim Amin, W. A., Abd El Hafiez, A. I., Beshir, H., Elsayed, Y. A., Elhamami, M. M., Moneim Wahby, E. A., Gamil, E. E. & Elminshawy, A. (2022). Thoracic surgery in Egypt. Journal of Thoracic Disease, 14(4), 1282-1295. https://doi.org/10.21037/jtd-21-723
Port Said Scientific Journal of Nursing
Volume 11, Issue 4
December 2024
Pages 124-161

Files

Share

How to cite

Statistics