title: The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery.
abstract: 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 PaO (2) increased by 0.2 kPa (p < 0.05), while PaCO (2) was unchanged in the three groups. Conclusion--A significant decrease of atelectatic area, increase in aerated lung area and a small increase in PaO (2) were found after performance of 30 deep breaths. No difference between the three breathing techniques was found.
authors.affiliation: Department of Medical Sciences, Clinical Physiology, University Hospital, Uppsala, Sweden. elisabeth.westerdahl@orebroll.se
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Westerdahl
authors.forename: Birgitta
authors.initials: B
authors.lastname: Lindmark
authors.forename: Tomas
authors.initials: T
authors.lastname: Eriksson
authors.forename: Göran
authors.initials: G
authors.lastname: Hedenstierna
authors.forename: Arne
authors.initials: A
authors.lastname: Tenling
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D001945:Breathing Exercises; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000534:rehabilitation*; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome