The Effects Incentive Spirometry Use in Coronary Artery Bypass Surgery

This study was designed as a single-center, randomized controlled trial with repeated measures to evaluate the effects of incentive spirometry used in addition to routine postoperative pulmonary rehabilitation in patients undergoing coronary artery bypass graft surgery.

The study was planned to be conducted in the cardiovascular surgery clinic of a university hospital. Patients assessed for eligibility were to be randomized into two groups: an experimental group (receiving incentive spirometry plus routine pulmonary rehabilitation) or a control group (receiving routine pulmonary rehabilitation only).

Randomization was performed using a simple randomization method with a computer-generated random number table. Group assignments were placed in sequentially numbered sealed envelopes to ensure allocation concealment. A single-blind approach was used during randomization, where the principal investigator and the statistician remained blinded to group assignments.

In the experimental group, it was planned that patients would receive routine pulmonary rehabilitation together with incentive spirometry. The device intended for use was a flow-oriented incentive spirometer with three chambers (target volumes: 600, 900, and 1200 mL). The intervention was planned to be initiated postoperatively after extubation and continued throughout the hospital stay. The procedure involved 10 to 20 deep breaths every 1 to 2 hours, combined with coughing exercises.

The control group was planned to receive routine pulmonary rehabilitation care without incentive spirometry. This care included deep breathing and coughing exercises, pain assessment, and early mobilization. Early mobilization was planned for both groups.

Data collection was planned to be performed during the preoperative period and across the early postoperative period (Days 1, 2, and 3). Recorded variables were intended to include demographic characteristics, arterial blood gas values (PaO2, PaCO2, SaO2), peripheral oxygen saturation (SpO2), and vital signs (systolic/diastolic blood pressure, respiratory rate, and pulse rate).

Inclusion criteria

• Patients undergoing first-time, nonemergency coronary artery bypass graft surgery
• Patients who agreed to participate in the study
• Patients who were able to communicate

Patients with no hearing difficulty

Patients with no history of psychiatric and/or mental illness

-Patients with a stable clinical condition

Exclusion criteria

• Patients with an unstable clinical condition
• Patients who refused to participate
• Patients with chronic obstructive pulmonary disease
• Patients with chronic kidney failure
• Patients with severe hemodynamic dysfunction
• Patients requiring sternotomy or re-sternotomy
• Patients requiring prolonged mechanical ventilation