The efect of preoperative deep breathing exercise with incentive spirometer initiated in the preoperative period on respiratory parameters and complications in patients underwent open heart surgery: a randomized controlled trial

Öner Cengiz H., Uluşan Özkan Z., Gani E.

BMC ANESTHESIOLOGY, vol.25, pp.36-49, 2025 (SCI-Expanded)

  • Publication Type: Article / Article
  • Volume: 25
  • Publication Date: 2025
  • Doi Number: 10.1186/s12871-025-02902-9
  • Journal Name: BMC ANESTHESIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Page Numbers: pp.36-49
  • Ankara University Affiliated: Yes

Abstract

Background: Incentive spirometer is used in lung expansion therapy to maintain alveolar patency and improve pulmonary volumes in postoperative cardiac surgical patients. Deep breathing exercises with an incentive spirometer signifcantly reduce the development of postoperative pulmonary complications after open-heart cardiac surgery.

Aim: To determine the efect of deep breathing exercises with an incentive spirometer initiated in the preoperative period on respiratory parameters and complications in patients who underwent open-heart surgery.

Methods: This randomized controlled study was conducted with a total of 66 participants. The participants were randomized into a deep breathing group (n=32) and a control group (n=34). The control group received hospital routine physiotherapy, and the deep breathing group started to perform deep breathing exercises with an incentive spirometer in the preoperative period. Data were collected with the Sociodemographic and Medical Data Form and Patient Follow-up Form (respiratory rate, oxygen saturation (SpO2) level, arterial blood gas parameters and posteroanterior chest X-ray were monitored with this form prepared by the investigators). The Medical Research Council Scale was used to determine the severity of dyspnea in the patients included in the study. Primary outcomes included respiratory rate, oxygen saturation, arterial blood gas parameters, posteroanterior chest X-ray, and evaluation of postoperative pulmonary complications development. Secondary outcomes included the mechanical ventilation time, length of intensive care unit stay, and length of hospital stay. Results The incidence of postoperative pulmonary complications was 3.1% and 23.5% (p<0.05) in the deep breathing and control groups, respectively. The mechanical ventilation time, length of hospital stay, and length of stay in the intensive care unit were signifcantly shorter in the deep breathing group (p<0.05). In the deep breathing group, the mean SpO2 values evaluated before surgery, on the frst day in the Cardiovascular Surgery Unit, and on the day of discharge were signifcantly higher than the control group (p<0.05).

Conclusion: Deep breathing exercises with an incentive spirometer initiated in the preoperative period contribute to a reduction in postoperative pulmonary complication rates, shortening of mechanical ventilation time, length of stay in the intensive care unit, length of hospital stay, and improvement of pre- and postoperative oxygenation.