Recovery of Respiratory Function After Coronary Artery Bypass Graft Surgery Using Pep-Therapy

Abstract

Background: Bronchopulmonary complications after CABG remain one of the main reasons for the increase in hospital mortality. A number of works showed the effectiveness of using PEEP-therapy and oPEEP-therapy in pulmonary pathology. However there was no direct comparison of the effectiveness of these methodic approaches in cardiac surgery patients. Objective: Due to this, the study objective was to study the effectiveness of recovery of respiratory parameters after coronary artery bypass graft using different device methods: PEEP-therapy and vibration PEEP-therapy. Methods: We studied 45 patients who underwent CABG. Patients were divided into 3 groups: Group I (control) - incentive spirometry was not performed after surgery, group II - PEEP-therapy was performed with EzPAP (USA), group III - oPEEP-therapy was performed with Acapella device (USA). Spirometry test was performed using device SMP-2101-RD (Russia). Results: Studies showed, that on the second day post-surgery in groups I, II and III vital capacity decreases by 42%, 35%, 34% (P < 0.01), and forced vital capacity - by 46%, 32%, 35% (P < 0.01) respectively. In patients of all studied groups there is detected statistically significant decrease of PFER, AFER 25 - 75, MFER 25, MFER 50, MFER 75. On day five after surgery in the patients of second group vital capacity and forced vital capacity reached pre-surgery level, while in the group I these parameters decreased by 31% and 34%, and in group III - by 25% and 26% respectively. On the ninth day after surgery vital capacity and forced vital capacity in groups II and III reached pre-surgery level, while in group I these values remained decreased by 28%, 32%, respectively. Conclusions: Carrying out PEEP therapy after coronary artery bypass surgery with EzPAP incentive spirometer allows the restoration of volumetric and velocity respiratory values at the moment of patient discharge from the hospital, whereas after vibrational PEEP therapy the Acapella device restores only volumetric values, and in the patients of the control group, recovery does not occur.