Institutional members access full text with Ovid®

Share this article on:

Effect of Preoperative Inspiratory Muscle Training on Alveolar-Arterial Oxygen Gradients After Coronary Artery Bypass Surgery

Turky, Khalid PhD; Afify, Amera M. Abdelaziz PhD

Journal of Cardiopulmonary Rehabilitation & Prevention: July 2017 - Volume 37 - Issue 4 - p 290–294
doi: 10.1097/HCR.0000000000000234
Pulmonary Rehabilitation

Purpose: Gas exchange abnormalities and inspiratory muscle dysfunction are common postoperative pulmonary complications after cardiac surgery. The aim of this study was to investigate the changes in the alveolar arterial oxygen gradients and inspiratory muscle power after preoperative inspiratory muscle training (IMT) followed by postoperative IMT and early mobilization after coronary artery bypass graft surgery.

Methods: Patients were randomly assigned to the intervention group (n = 20) or the usual care group (n = 20). The intervention group received preoperative IMT by a threshold load inspiratory muscle trainer and education followed by postoperative IMT and early mobilization. The usual care group received preoperative education and postoperative routine physical therapy care. Alveolar-arterial oxygen gradients and oxygen saturation were measured before induction of anesthesia and postoperatively immediately after extubation, at 24 hours, 48 hours, and on day 8 postsurgery. Inspiratory muscle power was measured before surgery, after 48 hours, and on day 8.

Results: Forty male patients underwent coronary artery bypass graft surgery. The intervention group showed significant (P < .05) improvement of alveolar arterial-oxygen gradients and inspiratory muscle power at all measurement points. The mean of inspiratory muscle power at discharge was significantly higher than at baseline but not statistically significantly different from the preoperative measurement.

Conclusion: Pre- and postoperative IMT by the threshold load inspiratory muscle trainer resulted in improvement of inspiratory muscle power, alveolar-arterial gradient, and oxygen saturation.

This study investigated the changes in alveolar-arterial oxygen gradients and inspiratory muscle power in patients who underwent coronary artery bypass graft and did and did not receive pre- and postoperative inspiratory muscle training. Results demonstrated that the training resulted in improvement of inspiratory muscle power and alveolar-arterial gradient.

Faculty of Physical Therapy, October 6 University, 6th of October City, Geza, Egypt.

Correspondence: Khalid Turky, PhD, October 6 University, Central Axis—Plot 1, 6th of October City, Giza 12585, Egypt (khturky@yahoo.com).

All authors have read and approved the article.

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.