title: Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial.
abstract: OBJECTIVE
  Breathing exercises after cardiac surgery are often performed in a sitting position. It is unknown whether oxygenation would be better in the standing position. The aim of this study was to evaluate oxygenation and subjective breathing ability during sitting vs standing performance of deep breathing exercises on the second day after cardiac surgery.
  
  
  METHODS
  Patients undergoing coronary artery bypass grafting (n = 189) were randomized to sitting (controls) or standing. Both groups performed 3 × 10 deep breaths with a positive expiratory pressure device. Peripheral oxygen saturation was measured before, directly after, and 15 min after the intervention. Subjective breathing ability, blood pressure, heart rate, and pain were assessed.
  
  
  RESULTS
  Oxygenation improved significantly in the standing group compared with controls directly after the breathing exercises (p < 0.001) and after 15 min rest (p = 0.027). The standing group reported better deep breathing ability compared with controls (p = 0.004). A slightly increased heart rate was found in the standing group (p = 0.047).
  
  
  CONCLUSIONS
  After cardiac surgery, breathing exercises with positive expiratory pressure, performed in a standing position, significantly improved oxygenation and subjective breathing ability compared with sitting performance. Performance of breathing exercises in the standing position is feasible and could be a valuable treatment for patients with postoperative hypoxaemia.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, , Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Pettersson
authors.forename: Gun
authors.initials: G
authors.lastname: Faager
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Westerdahl
mesh_terms: D000368:Aged; D001945:Breathing Exercises / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D015656:Respiratory Mechanics / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D010100:Oxygen