Evaluation of the effectiveness of external percussion and vibroacoustic chest massage in respiratory rehabilitation in cardiac surgery patients: a randomized controlled trial

INTRODUCTION: Respiratory rehabilitation used for cardiac surgery patients with impaired sputum evacuation, is an important aspect of the prevention of postoperative pulmonary complications. OBJECTIVE: To compare the effectiveness of the external percussion and vibroacoustic chest massage, against of the planned incentive spirometry in the early postoperative period of cardiosurgery patients. MATERIALS AND METHODS: A randomized prospective study included 90 patients who underwent elective cardiac surgery. Vibroacoustic lung massage (VLM) was performed with “VibroLUNG”in the 1st group (30 patients), high-frequency percussion of the chest followed by the intermittent airway pressure (HFP+IP) with “Comfort Cough Plus” devise was performed in the 2nd group (30 patients). Procedures started 10–12 hours after trachea extubation and were performed 3 times a day during 3 days after surgery. A control group included 30 patients in whom incentive spirometry was used. The following parameters were measured on the 1st and 3rd days: SpO2 (on room air) and volumetric parameters using bedside spirometry. RESULTS: VLM improved sputum clearance, increased mean SpO2 by 4 % (p < 0.001), reduces the number of patients with low MIC (maximal inspiratory capacity < 1200 ml) by 3.6 times (p = 0.004) and increase mean VC (Vital Capacity) by 432 ml (p = 0.034). HFP-IP increased mean SpO2 by 4.5 % (p < 0.001), decreased the number of patients with MIC ≤ 1200 ml by 5.7 times (p = 0.002), and increase mean VC by 574 ml (p = 0.016). In the control group no significant changes were noted. Respiratory rehabilitation decreased the number of the patients with radiological signs of hypoventilation: in the group of VLM by 7.33 times (p < 0.001), and in the group of HFP+IP by 6.48 times (p = 0.001). СONCLUSIONS: Methods of mechanical impact on the chest wall during postoperative rehabilitation of cardiosurgical patients are safe. They have a positive effect on the bronchopulmonary clearance and significant advantages over the control in their effect of sputum clearance, gas exchange, respiratory function and Xray signs of hypoventilation.