Lobectomy patients frequently experience postoperative respiratory complications such as secretion retention, dyspnea, impaired gas exchange, and reduced lung function, which can delay recovery. Oscillatory Positive Expiratory Pressure (OPEP) devices such as Acapella and Flutter are commonly used to improve airway clearance and pulmonary function. This study aims to compare the effects of Acapella and Flutter devices on secretion clearance, dyspnea, arterial blood gases, and lung function in post-lobectomy patients.
Lobectomy is a common surgical procedure performed for the treatment of various pulmonary conditions, particularly lung cancer. Although effective, the procedure is often associated with postoperative respiratory complications including mucus retention, reduced lung volumes, impaired ventilation, and difficulty breathing. These complications can prolong hospital stay, increase the risk of infection, and negatively affect functional recovery. Respiratory physiotherapy plays an important role in preventing and managing these complications. Oscillatory Positive Expiratory Pressure (OPEP) devices are widely used to facilitate airway clearance by generating positive expiratory pressure and oscillations during exhalation. These mechanisms help mobilize retained secretions, improve ventilation, enhance lung expansion, and support overall pulmonary recovery. Acapella and Flutter are two commonly used OPEP devices. Both have demonstrated beneficial effects on mucus clearance, pulmonary function, oxygenation, and symptom management in patients with respiratory disorders and postoperative conditions. Previous studies have reported improvements in respiratory parameters and functional outcomes following the use of these devices as part of pulmonary rehabilitation programs. Despite the growing use of OPEP devices in clinical practice, evidence directly comparing Acapella and Flutter in patients recovering from lobectomy remains limited. Most available studies have focused on chronic respiratory diseases or evaluated these devices independently rather than comparing their effectiveness in a postoperative population. Furthermore, limited information is available regarding their relative effects on secretion clearance, dyspnea, arterial blood gases, and lung function after lobectomy. Therefore, this study is designed to address this gap and provide evidence regarding the comparative effectiveness of Acapella and Flutter devices in postoperative pulmonary rehabilitation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
28
1\. Acapella Device Therapy (Experimental Arm 1): Participants will use the Acapella device, which provides a combination of oscillating positive expiratory pressure (OPEP) and airway vibration to facilitate mucus clearance. Patients will be trained in proper technique and will perform the intervention twice daily for 7 days. Each session will follow a standardized protocol to ensure consistency in breathing pattern and device usage.
Flutter Device Therapy (Experimental Arm 2): Participants will use the Flutter device, which generates oscillating positive expiratory pressure during exhalation to mobilize bronchial secretions. Patients will be instructed in correct positioning and breathing technique. The intervention will also be administered twice daily for 7 days using a standardized protocol.
Riphah International University
Lahore, Punjab Province, Pakistan
RECRUITINGChange in Dyspnea Score
Change in perceived breathlessness measured using the Modified Borg Dyspnea Scale (0-10, higher scores indicate greater dyspnea).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Forced Expiratory Volume in One Second (FEV₁)
Forced Expiratory Volume in one second (FEV₁) measured using spirometry and reported in liters (L).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Forced Vital Capacity (FVC)
Forced Vital Capacity (FVC) measured using spirometry and reported in liters (L).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
FEV₁/FVC Ratio
Ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV₁/FVC) measured using spirometry and reported as a percentage (%).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Sputum Volume
Volume of sputum expectorated over a 24-hour period, reported in milliliters (mL), to assess airway secretion clearance.
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Partial Pressure of Oxygen (PaO₂)
Arterial partial pressure of oxygen (PaO₂) measured using arterial blood gas analysis and reported in millimeters of mercury (mmHg).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Partial Pressure of Carbon Dioxide (PaCO₂)
Arterial partial pressure of carbon dioxide (PaCO₂) measured using arterial blood gas analysis and reported in millimeters of mercury (mmHg).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Arterial Blood pH
Arterial blood pH measured using arterial blood gas analysis.
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
Bicarbonate Concentration (HCO₃-)
Arterial bicarbonate (HCO₃-) concentration measured using arterial blood gas analysis and reported in millimoles per liter (mmol/L).
Time frame: Postoperative Day 1, Postoperative Day 3, and Postoperative Day 5
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