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

4 maj 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

42

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Grupp B
Enhet: 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

Andra namn:
  • Ankle pump
  • Bed pedal exercise
Inget ingripande: Group A

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
change in Length of stay
Tidsram: Total days 7
Length of stay in ward will be noted
Total days 7

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Riphah International University

Utredare

  • Huvudutredare: Wajeeha Zia, phd, Riphah International University

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna 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.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

10 maj 2026

Primärt slutförande (Beräknad)

2 augusti 2026

Avslutad studie (Beräknad)

2 augusti 2026

Studieregistreringsdatum

Först inskickad

23 februari 2026

Först inskickad som uppfyllde QC-kriterierna

4 maj 2026

Första postat (Faktisk)

7 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

7 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • Laiba rani
  • 64146 (Annan identifierare: riphah international university)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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