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The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery
Westerdahl E, Lindmark B, Eriksson T, Hedenstierna G, Tenling A
Scandinavian Cardiovascular Journal 2003 Dec;37(6):363-367
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of deep breathing performed on the second postoperative day after coronary artery bypass graft surgery. DESIGN: The immediate effects of 30 deep breaths performed without a mechanical device (n = 21), with a blow bottle device (n = 20) and with an inspiratory resistance-positive expiratory pressure mask (n = 20) were studied. Spiral computed tomography and arterial blood gas analyses were performed immediately before and after the intervention. RESULTS: Deep breathing caused a significant decrease in atelectatic area from 12.3 +/- 7.3% to 10.2 +/- 6.7% (p < 0.0001) of total lung area 1 cm above the diaphragm and from 3.9 +/- 3.5% to 3.3 +/- 3.1% (p < 0.05) 5 cm above the diaphragm. No difference between the breathing techniques was found. The aerated lung area increased by 5% (p < 0.001). The PaO2 increased by 0.2 kPa (p < 0.05), while PaCO2 was unchanged in the three groups. CONCLUSION: A significant decrease of atelectatic area, increase in aerated lung area and a small increase in PaO2 were found after performance of 30 deep breaths. No difference between the three breathing techniques was found.

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