title: [Incentive spirometry with expiratory positive airway pressure brings benefits after myocardial revascularization].
abstract: BACKGROUND
  Patients undergoing coronary artery bypass graft (CABG) surgery have higher risk to develop pulmonary complications (PCs) such as atelectasis, pneumonia and pleural effusion. These complications could increase the length of hospital stay, resources utilization and also are associated with reduced quality of life and functional capacity a long term.
  
  
  OBJECTIVE
  To test if the use of incentive spirometry (IS) associated with expiratory positive airway pressure (EPAP), after CABG surgery improves dyspnea, effort perceived and quality of life 18 months after CABG.
  
  
  METHODS
  Sixteen patients submitted to a CABG, were randomized to a control group (n=8) or IS+EPAP group (n=8). The protocol of IS+EPAP was applied in the immediate postoperative period and following for more 4 weeks in the patient's home. Eighteen months after CABG, the strength of the respiratory muscle, the functional capacity, the lung function, the quality of life and the level of physical activity were evaluated.
  
  
  RESULTS
  After six minute walk test (6-MWT), the score of the dyspnea (1.6+/-0.6 vs 0.6+/-0.3, P<0.05) and the perceived effort (13.4+/-1.2 vs 9.1+/-0.7, P<0.05) were higher in the control group, when compared with the IS+EPAP group. In quality of life evaluation, the domain related to the physical aspects limitations was better in IS+EPAP group (93.7+/-4.1 vs 50+/-17, P<0.02).
  
  
  CONCLUSIONS
  Patients that were submitted to IS+EPAP present reduction of dyspnea and lower effort sensation after the 6-MWT, and also a better quality of life 18 months after CABG.
authors.affiliation: HCPA, UFRGS, Porto Alegre, RS, Brasil.
authors.forename: Glória Menz
authors.initials: GM
authors.lastname: Ferreira
authors.forename: Mauren Porto
authors.initials: MP
authors.lastname: Haeffner
authors.forename: Sérgio Saldanha Menna
authors.initials: SS
authors.lastname: Barreto
authors.forename: Pedro
authors.initials: P
authors.lastname: Dall'Ago
mesh_terms: D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008168:Lung / Q000502:physiology; D008171:Lung Diseases / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects* / Q000534:rehabilitation; D011175:Positive-Pressure Respiration / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications / Q000517:prevention & control*; D011788:Quality of Life; D013147:Spirometry / Q000379:methods