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NCT Number: NCT07591987

Effect of Different Breathing Techniques on Dyspnea and Cardiopulmonary Parameters Among Patients After Open Heart Surgery

Open heart surgery is often associated with postoperative pulmonary complications, reduced lung expansion, dyspnea, and impaired cardiopulmonary function. Breathing exercises are commonly used after surgery to improve lung ventilation, enhance oxygenation, and support respiratory recovery. However, limited evidence is available comparing the effectiveness of segmental breathing exercises and active cycle breathing technique (ACBT) in patients after open heart surgery.

This randomized controlled trial will compare the effects of segmental breathing exercises and ACBT on dyspnea and cardiopulmonary parameters in adults undergoing open heart surgery. Participants will be randomly assigned to either the segmental breathing exercise group, the ACBT group, or the standard care group during the postoperative period following extubation.

Cardiopulmonary parameters, including oxygen saturation, respiratory rate, heart rate, and blood pressure, as well as dyspnea severity and postoperative pulmonary complications, will be assessed before and after the interventions.

The findings of this study may help identify the most effective breathing exercise technique for improving respiratory outcomes, reducing postoperative pulmonary complications, and supporting evidence-based postoperative rehabilitation after cardiac surgery.

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Key information

Conditions

Dyspnea Arterial Occlusive Diseases Arteriosclerosis Cardiopulmonary Dysfunction Cardiovascular Diseases Coronary Artery Disease Coronary Disease Heart Diseases Myocardial Ischemia Pathological Conditions, Signs and Symptoms Postoperative Respiratory Dysfunction Respiration Disorders Respiratory Tract Diseases Signs and Symptoms Signs and Symptoms, Respiratory Vascular Diseases

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ibn Al-Bitar Specialized Hospital for Cardiac Surgery, Baghdad, Baghdad Governorate, Iraq

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About this study

This randomized clinical trial evaluates the effects of segmental breathing exercises (SBE) and active cycle breathing technique (ACBT) on dyspnea, cardiopulmonary parameters, and postoperative pulmonary complications in adults undergoing elective open-heart surgery with cardiopulmonary bypass.

Participants will be randomly assigned to one of three groups: segmental breathing exercises group, active cycle breathing technique group, or standard care group. Patients in the intervention groups will perform the assigned breathing exercises after extubation, including sessions conducted 1 hour and 6 hours post-intervention during the early postoperative period.

Cardiopulmonary parameters, including oxygen saturation, respiratory rate, heart rate, and blood pressure parameters, will be monitored throughout hospitalization. Dyspnea and postoperative pulmonary complications, including atelectasis and pneumonia, will also be assessed.

The primary purpose of this study is to determine the effectiveness of breathing exercise interventions in improving postoperative respiratory outcomes and reducing pulmonary complications after cardiac surgery. The study also aims to support evidence-based postoperative rehabilitation practices for healthcare professionals caring for patients after open-heart surgery.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18-75 years.
  • Scheduled for elective open-heart surgery.
  • Can understand instructions and perform Segmental breathing and Active cycle breathing techniques.
  • Stable preoperative hemodynamic condition.

Exclusion criteria

  • Emergency cardiac surgeries.
  • Patients with pre-existing severe pulmonary disease (e.g., COPD, asthma, restrictive lung disease, Atelectasis, and Tuberculosis).
  • Neurological disorders affecting breathing effort.
  • Patients with rib fractures, recent thoracic trauma, or contraindications for coughing maneuvers.
  • Inability to provide informed consent (cognitive impairment, language barrier).

Treatment and study plan

Segmental Breathing Exercises

Behavioral

Deep breathing exercises focusing on specific lung segments to improve ventilation, lung expansion, and oxygenation in post open heart surgery patients.

Active Cycle Breathing Technique

Behavioral

A combination of breathing control, thoracic expansion exercises, and forced expiration technique to improve airway clearance and lung function.

Standard Postoperative Care

Other

Participants will receive routine postoperative care according to institutional protocols following cardiac surgery. This includes standard medical and nursing management such as oxygen therapy, pain control, monitoring of vital signs, and mobilization as tolerated, without additional structured respiratory physiotherapy interventions.

Primary outcomes

  1. Oxygen Saturation (SpO₂)

    Time frame: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay

    Assessment of peripheral oxygen saturation in patients after open heart surgery undergoing breathing exercises (segmental breathing exercises or active cycle breathing technique)

  2. Respiratory Rate

    Time frame: Measurements will be obtained at baseline pre-intervention,1 hour post-intervention, and 6 hours post-intervention

    Assessment of respiratory rate in patients after open heart surgery undergoing breathing exercises.

  3. Heart Rate

    Time frame: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay

    Assessment of heart rate in patients after open heart surgery undergoing breathing exercises.

  4. Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure

    Time frame: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay

    Assessment of Systolic Blood Pressure Pulse Pressure, and Diastolic Blood Pressure in patients after open heart surgery undergoing breathing exercises.

Secondary outcomes

  1. Dyspnea Index

    Time frame: measur at baseline pre-intervention and post-intervention after 6 hours.

    Assessment of dyspnea index in patients after open heart surgery using a standardized dyspnea scale contain ten questions for score 0 = Never. 1 = Almost never. 2 = Sometimes. 3 = Almost always. 4 = Always , the higher number is the worst that to evaluate changes before interventions and after implementation of segmental breathing exercises or active cycle breathing techniques.

Other outcomes

  1. Mean Arterial Pressure

    Time frame: Measurements will be obtained at baseline pre-intervention, 1 hour post-intervention, and 6 hours post-intervention during hospital stay

    Assessment of Mean Arterial Pressure in patients after open heart surgery undergoing breathing exercises.

Study contacts

Contact information is provided by the study sponsor or research team.

Muslim Aqeel Essa, Master Student

CONTACT

[email protected]

+9647822218483

Rusul Khalid Kadhim, Master Student

CONTACT

Sponsors and collaborators

Lead sponsor

University of Baghdad

Other

Registry information

Official study title

Effect of Segmental Breathing Versus Active Cycle Breathing Techniques on Dyspnea and Cardiopulmonary Parameters Among Patients After Open Heart Surgery: Randomized Controlled Trial.

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
May 18, 2026
Registry last updated
May 18, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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