Supervised vs Non-Supervised Incentive Spirometry After CABG

Universitas Padjadjaran38 enrolled

Overview

This study aims to evaluate the effect of supervised incentive spirometry (SIS) compared to unsupervised incentive spirometry (Non-SIS) on pulmonary function in patients following coronary artery bypass graft (CABG) surgery. Participants perform incentive spirometry exercises twice daily for three days after extubation. Pulmonary function parameters, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), are assessed before and after the intervention period to compare changes between the two groups.

Coronary artery bypass graft (CABG) surgery is associated with an increased risk of postoperative pulmonary complications, such as atelectasis, pneumonia, and pleural effusion, which may impair pulmonary function. Incentive spirometry (IS) is commonly used as part of postoperative care to promote deep breathing, enhance alveolar recruitment, and improve lung volumes. This quasi-experimental study is conducted at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, and enrolls patients who have undergone CABG surgery. Participants are consecutively assigned to one of two intervention groups: supervised incentive spirometry (SIS) or unsupervised incentive spirometry (Non-SIS). Participants in the SIS group perform incentive spirometry exercises under direct supervision by healthcare personnel twice daily to ensure correct technique and adherence. Participants in the Non-SIS group perform the same exercises independently with routine reminders. Both groups receive a standardized postoperative cardiac rehabilitation program. Pulmonary function is assessed using a portable spirometer measuring forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). Measurements are conducted at 24 hours post-extubation (T1) and after three days of incentive spirometry exercises (T2). The primary objective is to compare changes in pulmonary function parameters between the supervised and unsupervised groups.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Conditions

Postoperative Pulmonary Function Impairment

Interventions

Supervised Incentive Spirometry (SIS)PROCEDURE

Participants perform incentive spirometry exercises twice daily for 3 days under direct supervision. The supervisor monitors technique, corrects errors, answers questions, and ensures exercises are done accurately. Each session includes 6 sets of 5 breaths, with slow inhalation, 2-second breath-hold, and slow exhalation, separated by rest periods. This intervention is performed in addition to standard cardiac rehabilitation.

Non-Supervised Incentive Spirometry (Non-SIS)PROCEDURE

Exercises independently using a guideline form with daily reminders. Participants log activity. 6 sets of 5 breaths per session.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients aged ≥18 years. * Patients who have undergone Coronary Artery Bypass Graft (CABG) surgery. * Mechanical ventilation \<24 hours post-surgery. * Physically able to perform incentive spirometry (IS) exercises. * Signed informed consent to participate in the study. Exclusion Criteria: * Hemodynamically unstable patients. * Patients with cognitive or communication impairments. * Oral abnormalities that prevent the use of IS. * Patients with Chronic Obstructive Pulmonary Disease (COPD). * Patients with thoracic anomalies. * Patients who required reintubation. * History of incentive spirometry use within the last 3 months.

Locations (1)

RSUP Dr. Hasan Sadikin

Bandung, West Java, Indonesia

Outcomes

Primary Outcomes

Forced Expiratory Volume in 1 Second (FEV1)

Measures the volume of air that can be forcibly exhaled in one second to assess pulmonary function in post-CABG patients.

Time frame: T1 (24 hours post-extubation) and T2 (after 3 days of incentive spirometry exercise)

Secondary Outcomes

Forced Vital Capacity (FVC)

Measures the total volume of air that can be exhaled after a maximal inhalation to evaluate restrictive ventilatory patterns in post-CABG patients.

Time frame: T1 (24 hours post-extubation) and T2 (after 3 days of incentive spirometry exercise)

Data from ClinicalTrials.gov

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