Alam Masood, Hussain Shafqat, Shehzad Muhammad Imran, Mushtaq Azam, Rauf Abdul, Ishaq Sohaib
Pulmonology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan, PAK.
Cardiac Surgery, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan, PAK.
Cureus. 2020 Feb 3;12(2):e6851. doi: 10.7759/cureus.6851.
Objective To compare the effect of incentive spirometry with Acapella (Smiths Medical Inc, Carlsbad, California) in physiotherapy after coronary artery bypass surgery. Methods A randomized controlled trial comparing incentive spirometry with Acapella was conducted in the intensive care unit of Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan. The study began from December 2017 to August 2019 after getting approval from the ethical committee of the hospital. Informed written consent was taken from all 270 patients who were included in the study. Patients who underwent coronary artery bypass graft (CABG) were divided into two groups by the lottery method. The primary end-point of the study was to check the blood gases on Day 3 after the procedure at room air and compare it with the baseline and with blood gases immediately after the procedure. SPSS 23 (IBM Corp., Armonk, NY) was used to analyze the data of this study. For qualitative variables in data such as gender, place of living, patients with any comorbidities, and education status were statistically analyzed in percentage and frequencies. For numerical variables, such as age, body mass index, blood gases values, distance covered in a six-minute walk test, and spirometry values were analyzed and statistically measured as mean and standard deviation. A P-value of less than .05 was considered significant. Results The mean partial pressure of oxygen (PaO2) of incentive spirometry was 58.1±2.31 and 67.2±3.24 after extubation and after three days, respectively. While the PaO2 of Acapella was 56.3±3.43 and 66.4±3.54 after extubation and after three days, respectively. The mean PCO2 of incentive spirometry was 41.4±3.26 and 36.1±2.11 after extubation and after three days, respectively. While the partial pressure of carbon dioxide (PCO2) of Acapella was 39.4±2.55 and 37.5±3.58 after extubation and after three days, respectively. The differences were statistically significant at p-value ≤0.05. Conclusion It was concluded that both Acapella and incentive spirometry treatment after coronary artery bypass graft improved blood gases.
目的 比较激励式肺量计与阿凯拉(史密斯医疗公司,加利福尼亚州卡尔斯巴德)在冠状动脉搭桥术后物理治疗中的效果。方法 在木尔坦乔杜里·佩尔韦兹·埃拉希心脏病学研究所(CPEIC)重症监护病房进行了一项将激励式肺量计与阿凯拉进行比较的随机对照试验。该研究在获得医院伦理委员会批准后于2017年12月至2019年8月开始。对纳入研究的所有270例患者均取得了知情书面同意。接受冠状动脉搭桥术(CABG)的患者通过抽签法分为两组。该研究的主要终点是在术后第3天室内空气中检查血气,并将其与基线以及术后即刻的血气进行比较。使用SPSS 23(IBM公司,纽约州阿蒙克)分析本研究的数据。对于数据中的定性变量,如性别、居住地点、有任何合并症的患者以及教育状况,以百分比和频率进行统计分析。对于数值变量,如年龄、体重指数、血气值、六分钟步行试验所走距离以及肺量计值,进行分析并以均值和标准差进行统计测量。P值小于0.05被认为具有统计学意义。结果 激励式肺量计组拔管后和三天后的平均氧分压(PaO2)分别为58.1±2.31和67.2±3.24。而阿凯拉组拔管后和三天后的PaO2分别为56.3±3.43和66.4±3.54。激励式肺量计组拔管后和三天后的平均二氧化碳分压(PCO2)分别为41.4±3.26和36.1±2.11。而阿凯拉组拔管后和三天后的二氧化碳分压(PCO2)分别为39.4±2.55和37.5±3.58。差异在p值≤0.05时具有统计学意义。结论 得出结论,冠状动脉搭桥术后阿凯拉和激励式肺量计治疗均能改善血气。