Comparison of incentive spirometry and oscillating positive expiratory pressure devices for pulmonary rehabilitation after coronary artery bypass graft surgery

Scritto il 20/02/2026
da Ali Bolat

Cardiovasc J Afr. 2025 Oct 17;36(4):478-484. doi: 10.5830/CVJA-2025-067. Epub 2025 Oct 17.

ABSTRACT

OBJECTIVE: Coronary artery bypass graft (CABG) surgeries, which are used in the treatment of coronary artery disease are still generally performed under cardiopulmonary bypass (CPB). In addition to the mechanical effects of the surgery, pulmonary complications due toCPB are common. This study aimed to compare the effects of incentive spirometry (IS) and oscillating positive expiratory pressure (OPEP) devices used after CABG surgery on pulmonary system rehabilitation.

METHODS: Two hundred and fifty-three coronary artery disease patients who underwent CABG were analysed retrospectively. The patients were divided into two groups: those using IS (n = 52) devices and those using OPEP (n = 52) devices. Arterial blood gases were evaluated on the 1st, 2nd, and 3rd postoperative days, and the 6-minute walking test (6MWT) was performed on the 2nd and 3rd postoperative days.

RESULTS: The PO2, PCO2, and SaO2 values measured on the 2nd and 3rd postoperative days showed significant improvement in Group OPEP compared to Group IS (p = 0.016, 0.006, 0.031,0.039, 0.022, and 0.003, respectively). As a result of 6MWT performed on the 2nd and 3rd postoperative days, walking distance increased more in Group OPEP compared to Group IS (p < 0.001 and 0 < 0.001, respectively). In Group OPEP, both the length of stay in the intensive care unit and the length of hospital stay were found to be lower (p = 0.005 and p < 0.001, respectively).

CONCLUSION: As a result of this study, we think that the use of OPEP devices in pulmonary rehabilitation will be beneficial in preventing pulmonary complications after CABG.

ABBREVIATIONS: ABG: Arterıal blood gas, CABG: Coronary artery bypass graft, CAD: Coronary Artery Disease, COPD: Chronic Obstructive Pulmonary Disease, CPB: Cardiopulmonary Bypass, DM: Diabetes mellutus, ECHO: Echocardiography, EF: Ejection Fraction, EPAP: Expiratory positive airway pressure, EZPAP: Positive Airway Pressure Therapy System, FEV1: Volume Of Air Exhaled İn The 1st Second Of Forced Expiration, HL: Hyperlipidaemia, HT: Hypertension, IS: Incentive Spirometry, MİN: MİNİMUM, MAX: MAXİMUM, IMA: İnternal Mammary Artery, OPEP: Oscillating Positive Expiratory Pressure, PAD: Peripheral artery disease, PEFR: Peak Expiratory Flow Rate, PEP: Positive Expiratory Pressure, RD: Renal dysfunction, STD: Standard Deviation, 6MWT: 6 Minutes Walking Test.

PMID:41718632 | DOI:10.5830/CVJA-2025-067