Respiratory Physiotherapy After Cardiac Surgery

Inspiratory Volume and Muscle Recruitment During Breath-stacking and Incentive Spirometry Techniques in Postoperative Cardiac Patients

Although incentive spirometry is commonly used to avoid pulmonary complications in cardiac surgery patients, the breath-stacking technique has been proposed as an alternative to increase pulmonary volumes in the post-operative period.

Objective: To compare inspiratory volume and electromyographic activity of respiratory muscles during breath stacking technique and incentive spirometry in patients undergoing cardiac surgery.

The purpose of the present study are:

1. to evaluate and compare the inspiratory volume during the course of Breath Stacking and Incentive Spirometry techniques in patients submitted to myocardial revascularization surgery.
2. to compare the electromyographic activity of the scalene, sternocleidomastoid (SCM) and diaphragm muscles during both techniques.

Inclusion Criteria:

• patients submitted to myocardial revascularization surgery

Exclusion Criteria:

• cognitive impairment or incoordination to perform IS
• face mask intolerance during BS
• level of consciousness incompatible to perform IS
• hemodynamic complications [arrhythmia, intraoperative myocardial infarction, major blood loss (defined as a loss of ≥20% of total blood volume), mean arterial pressure <70 mmHg and reduce cardiac output requiring the use of an intra-aortic balloon pump or vasoactive drugs)
• intubation for more than 72 h after admission to the Intensive Care Unit
• the need for reintubation.