Evaluation of the Effectiveness and Safety of Vibro-acoustic Pulmonary Therapy (VAPT) in Complex Therapy for Acute Respiratory Failure of Mixed Type I-II Stages in Comparison With Percussion Massage in Cardiac Surgical Patients in the Early Postoperative Period

Inclusion Criteria: * Age from 18 years to 80 years inclusive * Body mass index from 18.5 to 35 * Physical status according to ASA II to ASA III (inclusive) * Performed planned cardiac surgery (CS) under general anaesthesia with tracheal intubation and mechanical ventilation lasting more than 3 hours using a heart-lung machine (no more than 120 minutes) * Left ventricular injection fraction before surgical treatment is above 40% * Development of postoperative mixed ARF grade 1-2 (clinical criteria). SpO2 less than 95% with FiO2 21%. * Stable-severe condition of the patient according to vital signs: 1. stable hemodynamics (norepinephrine and/or adrenaline less than 0.15 mcg/kg/min, and/or dobutamine less than 10 mcg/kg/min, and/or no need for vasopressin (ADH) for 6 hours or more) 2. absence of acute kidney injury (urine output more than 500 ml/day) 3. stable respiratory dynamics.P/F more than 150 units, SpO2 more than 70% with FiO2 21%.Tracheal extubation within 8 hours of completion of surgery 4. absence of critical coagulopathy (platelets more than 50 units/l) 5. absence of acute cerebral insufficiency (GCS more than 12 points) 6. absence of acute liver failure (bilirubin less than 30 units/l) * Relieved postoperative pain syndrome and delirium (NRS less than 5 points, BPS less than 6 points, CAM-ICU (-), RASS -3-0 points). Exclusion Criteria: * The presence of implanted or external medical electronic-mechanical devices in the impact projection (pacemaker, circulatory support devices, etc.); * Severe hypocoagulation, risk of hematoma formation or bleeding in the projection of exposure; * Severe hypercoagulation, risk of formation and/or migration of blood clots or emboli along the great vessels in the projection of exposure; * Acute cerebrovascular accident (ACB), first 1-3 days; * Cerebral Edema; * High intracranial pressure; * The presence of many purulent or burn wound surfaces in the projection of exposure; * Presence of an unstable rib fracture; * Pneumohemomediastinum and/or subcutaneous emphysema of the chest; * Risk of development of hemo-pneumothorax; * Osteomyelitis of the ribs and/or thoracic spine; * Spinal fracture without orthopedic fixation; * Trauma to the chest or abdomen with bleeding; * High risk of seizures (CNS pathologies); * The presence of an oncological process in the projection of exposure with destruction of tumor tissue and the risk of bleeding and/or metastasis; * The presence of endothoracic and/or large endovascular implants (aortic stents, intra-aortic balloon pumps, endocardial catheters, mechanical heart valves, vena cava filters, subcutaneous venous ports, permanent hemodialysis devices); * Heart rhythm disturbances (ventricular fibrillation, ventricular tachycardia); * Hypovolemia; * Disturbances of water-electrolyte balance and acid-base balance; * Meningoencephalitis; * Destructive purulent pneumonia; * High risk of pulmonary hemorrhage; * Hiatal hernia; * Risk of dislocation of implanted drainage tubes and catheters; * The presence of multiple wound surfaces in the projection of exposure; * Severe bullous deformation of the lungs; * Severe kyphoscoliosis; * Spontaneous pneumothorax within the last year; * Estimated systolic pressure over the pulmonary artery more than 50 mm Hg. Art.