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Effects of E-care Protocol in Patients With Coronary Artery Bypass Graft (CABG)

4. maj 2026 opdateret af: Riphah International University

Effects of E-care Protocol in Length of Hospital Stay and Respiratory Failure in Patients With Coronary Artery Bypass Graft

Coronary artery disease (CAD) is a heart disease caused by the buildup of plaque inside the coronary arteries that restricts blood flow to the heart which leads to heart attack. If it involve more than one artery it will be more critical so the preferred treatment will be coronary artery bypass graft. Respiratory failure after Coronary Artery Bypass Grafting (CABG) is a serious complication with multifactorial causes i.e. pneumonia and atelectasis in inpatients.

Postoperative pulmonary complications will be diagnosed using the Melbourne Group Scale (MGS), applied daily from postoperative day 1 to day 7. A score of ≥4 positive criteria will be used to identify PPCs. The scale's criteria will include chest radiograph findings, oxygen saturation, sputum characteristics, inflammatory markers, and ventilation data, physician diagnosis of pneumonia, readmission to ICU for respiratory reasons, prolong ventilation> 24 hours, unplanned use of non-invasive ventilation.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The study will be randomized clinical trial. It will be conducted at Gulab Devi Chest Hospital Lahore, Pakistan. Total sample size will be 42. Attrition rate is 10%. The data will be analyzed using SPSS v25. Sample size will be conducted via non probability consecutive sampling technique as per inclusion criteria participants will be randomly assigned into two groups. Group A will receive standard rehabilitation treatment for inpatients. This includes the physical reconditioning, promote patient independence, Provide education about lifestyle changes and respiratory muscle strength. For example Day 1-2(Sitting up in bed or in a chair, Breathing exercises (incentive spirometer) and Coughing with pillow support (to protect the sternum).Day 2-3(Standing and walking short distances with assistance and Gentle range-of- motion (ROM) exercises. Day 4-5 (Walk longer distances (50-100 meters) and Stair climbing (if appropriate). It's necessary to monitor the vital signs (HR, BP, O2 saturation), pain levels, wound inspection and signs of orthostatic intolerance or arrhythmias. Group B will receive E- CARE protocol with IMT threshold device to improve respiratory muscle strength. This study focuses on the LOHS and the incidence of respiratory failure.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

42

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Male and female of >45 years diagnosed with CAD and are undergone Coronary Artery Bypass Graft with stable circulation.
  • Stable vitals.
  • With normal cognition and being able to cooperate with the CR training.
  • Agreed to participate in the trial and signed the consent for .

Exclusion Criteria:

  • Pregnant
  • Undergoing aortic surgery or equivalent surgery within 6 months
  • History of cardiogenic shock or sudden cardiac arrest and severe hypertension
  • Having complications with persistent ischemia, hemodynamic impairment, or at risk of arterial occlusion with massive myocardial infarction
  • Having complications with unstable angina, malignant arrhythmia

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Gruppe B
Enhed: IMT Threshold device

Group A will receive standard rehabilitation treatment for inpatients. This includes the physical reconditioning, promote patient independence, Provide education about lifestyle changes and respiratory muscle strength. For example Day 1-2(Sitting up in bed or in a chair, Breathing exercises (incentive spirometer) and Coughing with pillow support (to protect the sternum).Day 2-3(Standing and walking short distances with assistance and Gentle range-of- motion (ROM) exercises. Day 4-5 (Walk longer distances (50-100 meters) and Stair climbing (if appropriate). It's necessary to monitor the vital signs (HR, BP, O2 saturation), pain levels, wound inspection and signs of orthostatic intolerance or arrhythmias.

6.1 IMT (Inspiratory muscle training) via use of IMT threshold Device: In comfortable sitting position IMT threshold device will be applied to the patient. Device will properly fitted to the patients mouth and set the resistance according to the patient respiratory muscle strength af

Andre navne:
  • Ankle pump
  • Bed pedal exercise
Ingen indgriben: Group A

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
change in Length of stay
Tidsramme: Total days 7
Length of stay in ward will be noted
Total days 7

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Riphah International University

Efterforskere

  • Ledende efterforsker: Wajeeha Zia, phd, Riphah International University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

  • 14. Maisel, W.H., J.D. Rawn, and W.G.J.A.o.i.m. Stevenson, Atrial fibrillation after cardiac surgery. 2001. 135(12): p. 1061-1073.
  • 13. Rajaei, S. and A. Dabbagh, Risk factors for postoperative respiratory mortality and morbidity in patients undergoing coronary artery bypass grafting. Anesthesiology and Pain Medicine, 2012. 2(2): p. 60.
  • 12. Deb, S., et al., Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review. Jama, 2013. 310(19): p. 2086-2095.
  • 11. Kazem, S.S., et al., Pulmonary physiotherapy effect on patients undergoing open cardiac surgery. Russian open medical journal, 2014. 3(3): p. 306.
  • 10. Head, S.J., et al., Stroke rates following surgical versus percutaneous coronary revascularization. 2018. 72(4): p. 386-398
  • 9. Zanini, M., et al., Effects of different rehabilitation protocols in inpatient cardiac rehabilitation after coronary artery bypass graft surgery: a randomized clinical trial. Journal of cardiopulmonary rehabilitation and prevention, 2019. 39(6): p. E19-E25.
  • 8. Tajti, P., et al., In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Interventions in Patients with Prior Coronary Artery Bypass Graft Surgery: Insights From an International Multicenter Chronic Total Occlusion Registry. Circulation: Cardiovascular Interventions, 2019. 12(3): p. e007338.
  • 7. Members, W.C., et al., 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 2022. 79(2): p. 197-215
  • 6. Zhang, S., et al., The effects of inspiratory muscle training (IMT) on patients undergoing coronary artery bypass graft (CABG) surgery: a systematic review and meta-analysis. 2023. 24(1): p. 16.
  • 5. Hochman, J.S., et al., Survival after invasive or conservative management of stable coronary disease. Circulation, 2023. 147(1): p. 8-19.
  • 4. Fernandes, G.C., et al., Determinants of early and late in-hospital mortality after acute myocardial infarction: a subanalysis of the OBTAIN registry. 2023. 39(4): p. 531-537.
  • 3. Redfors, B., et al., Outcomes according to coronary revascularization modality in the ISCHEMIA trial. 2024. 83(5): p. 549-558.
  • 2. Araújo, C.O., et al., Inspiratory muscle training in phase 1 and 2 postoperative cardiac rehabilitation following coronary artery bypass graft surgery: systematic review with meta- analysis. Physical therapy, 2024. 104(7): p. pzae061.
  • 1. Yang Q, Wang L, Zhang X, Lu P, Pan D, Li S, Ling Y, Zhi X, Xia L, Zhu Y, Chen Y. Impact of an enhanced recovery after surgery program integrating cardiopulmonary rehabilitation on post-operative prognosis of patients treated with CABG: protocol of the ERAS-CaRe randomized controlled trial. BMC Pulmonary Medicine. 2024 Oct 14;24(1):512.Villareal, R.P., et al., Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. 2004. 43(5): p. 742-748.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

10. maj 2026

Primær færdiggørelse (Anslået)

2. august 2026

Studieafslutning (Anslået)

2. august 2026

Datoer for studieregistrering

Først indsendt

23. februar 2026

Først indsendt, der opfyldte QC-kriterier

4. maj 2026

Først opslået (Faktiske)

7. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

7. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Laiba rani
  • 64146 (Anden identifikator: riphah international university)

Plan for individuelle deltagerdata (IPD)

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Kliniske forsøg med CABG

Kliniske forsøg med IMT Threshold device

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