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4 . 2020

Evaluation of effectiveness of vibroacoustic lung massage self-breathing in patients after cardiosurgical operations

Abstract

AimTo study the efficacy of vibroacoustic lung massage with the help of postoperative VibroLung apparatus in cardiosurgical patients by its effect on gas exchange indices, parameters of external breathing and sputum passage. 

Material and methodsThe prospective study included 55 patients aged 19-80 years after elective cardiac surgery in Petrovsky National Research Center of Surgery in 2019. Inclusion criteria: age over 18 years, self-breathing after trachea extubation, possibility to maintain adequate gas exchange against the background of oxygen inhalation, clear consciousness and productive contact with the patient, adequate pain relief (VAS <2 on a 10-score scale). Exclusion criteria: necessity to carry out artificial pulmonary ventilation (IVL), non-invasive mask pulmonary ventilation or high-flow oxygenotherapy, acute cerebral circulation disorder, shocks of various etiologies, extracorporeal detoxification methods. All gas exchange indices were carried out when breathing with air.

ResultsIt has been found that 96.4% of cardiosurgical patients have difficulties in evacuating sputum during coughing in early times after trachea extubation. Vibration-acoustic massage of lungs by VibroLung apparatus is accompanied by significant improvement of sputum passage. After the session, the sputum pumping efficiency increased on average from 0.04±0.19 to 0.64±0.79 points (p<0.001). As a result of vibromassage, the number of patients with maximum inspiratory volume less than 500 ml decreased from 32.7 to 7.3%, and with MIO more than 1500 ml - increased from 14.5 to 45.1% (p<0.05).

ConclusionStatistically significant increase of maximum inspiratory volume after vibromassage on average by 44.1% (p<0.001) along with decrease by 19.7% (p=0.002) of fraction of intralegal shunning can be observed. Vibroacoustic lung massage was accompanied by improvement of gas exchange indices, as evidenced by statistically significant increase of 02 partial pressure in arterial blood and p/f index with simultaneous decrease of PaCO2 and increase of blood oxygen saturation.

Keywords:vibroacoustic lung massage VibroLung, ICU, cardiac surgery

Funding. This work was not sponsored.
Conflict of interests. The authors declare no conflict of interests.
Contribution. The concept and design of the study, editing the work - Eremenko A.A.; writing an article, partial processing of the material and collecting literature - Zyulyaeva T.P.; collection of material - Kalinina A.A.; statistics - Rozina N.A.
For citation: Eremenko A.A., Zyulyaeva T.P., Kalinina A.A., Rozina N.A. Evaluation of effectiveness of vibroacoustic lung massage in self-breathing patients after cardiosurgical operations. Clinical and Experimental Surgery. Petrovsky Journal. 2020; 8 (4): 126-34. DOI: https://doi.org/10.33029/2308-1198-2020-8-4-126-134 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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