Title: The Efficacy of Chest Physiotherapy on Ventilator Dependency and Length of Stay in Cardio Thoracic Intencive Care Unit: A Randomized Clinical Study
Authors: Dr V. Kiran M.P.T (Cardio), Dr Ravirajkuar.T, Dr C.Kodhandapani, Dr Niranjan Reddy, Dr Subbaiah
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.71
Abstract
BACKGROUND: A majority of cardiac surgery is performed for ischemic coronary artery disease. Coronary artery bypass grafting (CABG) surgery is commonly performed via a median sternotomy. A significant reduction in lung volumes were reported in patients after Median Sternotomy performed during cardiac surgery. There is a reduction of FVC, FEV1, PEFR and SPO2 levels. Subsequently, abnormalities in the chest wall mechanics may also occur that may influence the reduced lung function. Chest physiotherapy, Deep breathing exercises, Incentive spirometry are used to improve lung capacity and is been reported to be effective in reducing ventilator dependency, length of hospital stay by improving lung function.
SPECIFIC OBJECTIVE: -To determine the effectiveness of chest physiotherapy on ventilator dependency and length of hospital stay in patients with thoracic surgeries.
DESIGN: - Pre test – Post test with Comparison group (Quasi experimental design).
STUDY SETTING:- Department of Cardio Thoracic and Vascular Surgery, Narayana Medical College Hospitals, Nellore.
PARTICIPANTS:- A Group A-15 participants received chest physiotherapy and deep breathing exercises, incentive spirometry (duration of 15-20 minutes /session for 3 sessions/ day) and Group B-15 Participants received deep breathing exercises, incentive spirometry (15 minutes/ session for 3 sessions/day) for 6 days total of 30 patients who underwent thoracic surgeries.
OUTCOME MEASURES:- FVC, FEV1, PEFR and SPO2
RESULTS:- The patients in chest physiotherapy with incentive spirometry, deep breathing exercises group, showing the mean difference in FVC, FEV1, PEFR and SPO2 levels were 3.81,2.72, 485.3 and 98.5 respectively. The patients with incentive spirometry, deep breathing exercises alone, showing the mean difference of FVC, FEV1, PEFR and SPO2 levels were 2.26, 1.62, 429.1and 96.6 respectively. The comparison of paired “t” test value is 2.34. The calculated value is more than the table value, so there is a statistically significant difference between the comparison of Group A and Group B.
CONCLUSION: This study reveals that there was significant difference of improvement in FVC, FEV1, PEFR and SPO2 levels following chest physiotherapy with incentive spirometry, deep breathing exercises when compared to deep breathing exercises, incentive spirometry alone in patients undergoing thoracic surgeries.
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