Effect of Positioning Combined With Active Cycle of Breathing Techniques on Pulmonary Complications After Cardiac Surgeries
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 124
- 试验地点
- 1
研究概览
简要总结
The goal of this quasi-experimental clinical trial is to learn if position management combined with the Active Cycle of Breathing Techniques (ACBT) works to reduce postoperative pulmonary complications in adult patients undergoing elective cardiac surgery. It will also evaluate the individual effects of each technique compared to routine care.
The main questions it aims to answer are:
Does the combination of positioning and ACBT significantly lower the incidence and severity of postoperative pulmonary complications (like atelectasis, pneumonia, and respiratory failure) within the first 7 days after surgery? Does the combination of these techniques reduce the length of hospital stay compared to using each technique alone or routine care? Does the application of ACBT alone lower the rate of respiratory infections? Does position management alone improve oxygenation parameters (such as SpO_{2} and PaO_{2})?
Researchers will compare four groups of patients to determine the most effective nursing approach:
Group 1 (Control Group): Participants will receive routine postoperative hospital care only.
Group 2 (ACBT Group): Participants will perform the Active Cycle of Breathing Techniques (breathing control, thoracic expansion, and huffing) three times daily for 10-15 minutes over 5 postoperative days.
Group 3 (Positioning Group): Participants will receive structured position management exclusively, shifting from head elevation (30-45) early after surgery to a semi-recumbent position (approx60) during waking hours, alongside other positions like lateral or forward-leaning as tolerated.
Group 4 (Combined Group): Participants will receive both structured position management and perform the ACBT sessions according to the same schedules.
All participants will undergo daily respiratory assessments using a standardized scoring system for 7 days post-surgery or until hospital discharge.
详细描述
This quasi-experimental, non-equivalent control group study is designed to evaluate the clinical impact of position management, the Active Cycle of Breathing Techniques (ACBT), and their combined application on reducing postoperative pulmonary complications (PPCs) among adult patients undergoing elective cardiac surgery via median sternotomy.
Study Phases and Flow:
1. Preparatory Phase: Official administrative approvals will be secured from the director of the cardiothoracic care unit (CTCU) at Assiut University Heart Hospital. The data collection tools will be validated by a jury panel of five experts in medical-surgical nursing and cardiothoracic surgery.
Internal consistency will be evaluated using Cronbach's Alpha. A pilot study involving 10% of the sample size (13 patients) will be conducted to test feasibility and timing, and these patients will be excluded from the final analysis.
Eligible patients will be approached preoperatively to explain the study's purpose, benefits, and risks, and voluntary written informed consent will be obtained.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients (aged from 20 years to 65 years old).
- •Undergoing elective cardiac surgery (Coronary Artery bypass Grafting (CABG) or valves surgeries) via median sternotomy.
- •Hemodynamically stable postoperatively (no high-dose vasopressor support).
- •Fully conscious and capable of following complex verbal instructions.
排除标准
- •• Patients undergoing emergency cardiac surgery.
- •History of chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), bronchial asthma, or bronchiectasis
- •Pre-existing pulmonary complications (e.g., pneumonia, atelectasis, pleural effusion) prior to surgery
- •Neuromuscular disorders affecting respiratory muscles
- •Severe obesity (e.g., BMI ≥35 kg/m²)
- •Cognitive impairment or inability to follow instructions
- •Any contraindication to physiotherapy techniques (e.g., unstable sternum, severe pain not controlled)
研究者
Mahmoud Fathy Abdelhafeez Soliman
Assistant lecturer
Assiut University