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Effect of Positive Expiratory Pressure (PEP) Vs Routine Physiotherapy in preventing pulmonary complications following CABG Results of a pilot study

Ayesha Kishori Miranda , Ayesha Kishori Miranda , Narasimman Swaminathan , Cherisma D silva , Jayakrishnan A. J.

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Physiotherapy and Occupational Therapy Journal 5(2):p 51-58, April - June 2012. | DOI:

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Abstract

Chest physiotherapy is an established and routinely used therapy to prevent and treat post operative pulmonary complications after cardiac surgery. Positive expiratory pressure (PEP) is an expiratory resistance breathing exercise which has been incorporated into the routine post-operative regime after open heart surgery. The present study was aimed to evaluate and compare the efficacy of routine physiotherapy and PEP in preventing post-operative pulmonary dysfunction in patients undergoing CABG. Methods: Subjects (n=18) who underwent elective coronary artery bypass grafting were included in the study. They were randomly assigned into 2 groups. Group 1 was given PEP therapy and Group 2 were administered routine chest physiotherapy .Arterial Blood Gas, PFT (FEV1, FVC, PEFR,) SPO2 and 2 min walk distance were measured pre and post cardiac surgery.Data analysis and Results: 16 subjects completed the study. Fishers exact t test, Mann Whitney ‘U’ test and Wilcoxon Signed Ranks test were used compare the parameters between and with the groups. There was no significant difference in any of the outcomes between the groups.Conclusion: Positive Expiratory Pressure clinically as well as statistically has equal effects in preventing postoperative pulmonary complications when compared with conventional physiotherapy.

Keywords: physiotherapy; Thoracic surgery; Coronary artery bypass graft; Post-operative pulmonary complications; Positive expiratory pressure; Breathing exercises; Incentive spirometery.

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