Effects of precise airway management strategies on lung function and complications in patients after visceral surgery
10.3760/cma.j.cn421666-20250407-00307
- VernacularTitle:精准化气道管理策略对心脏外科术后患者肺部功能和并发症的影响
- Author:
Xiaoxiao MA
1
;
Chaohui WANG
;
Xinxin JIN
;
Shuyong LIANG
;
Shunchao YING
;
Zhiwei TANG
Author Information
1. 东阳市人民医院，东阳 322100
- Publication Type:Journal Article
- Keywords:
Cardiac surgery;
Airway management;
Breathing techniques;
Oscillatory positive expiratory pressure technique;
Pulmonary complications;
RALE scoring
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(11):991-997
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the active respiratory circulation technique (ACBT) with the oscillatory positive pressure expiration technique (OPEP) in terms of their ability to improve pulmonary function and minimize complications after cardiac surgery, seeking to define an airway management strategy for such patients.Methods:A total of 101 patients who had undergone cardiac surgery were randomly divided into an ACBT group ( n=50) and an OPEP group ( n=51). On the 1st day after the operation, in addition to conventional medical treatment and early rehabilitation, the subjects were additionally provided with daily 20-minute sessions of ACBT or OPEP training for seven consecutive days. Before the operation, and on the 3rd and 7th day afterward, lung function was assessed using a pulmonary edema imaging assessment system (RALE), computed tomography and pulmonary function indexes. Any complications were also noted. Six-minute walking distance and the Barthel index quantified exercise endurance and ability in the activities of daily living, respectively. Turbidimetry was used to determine the levels of C-reactive protein in the blood. The duration of mechanical ventilation required, ICU stay time, length of postoperative and total hospital stays were also recorded. Results:On day seven after the operation, the average RALE scores of the ACBT and OPEP groups were (12.40±4.37) and (10.20±4.66), respectively—a significant difference. At the same time point, the incidence of atelectasis in the OPEP group was significantly lower than in the ACBT group. The OPEP group′s average maximum inspiratory pressure was a greater percentage of the predicted value, and its average 6-minute walk and BI score were also better. On the 3rd day after the operation, the incidence of lung consolidation in the ACBT group was significantly lower than that in the OPEP group, on average.Conclusions:The curative effect of ACBT is better than that of OPEP in the first few days after such an operation, but after a week OPEP more effectively restores respiratory muscle strength and relieves pulmonary complications. It is recommended to apply these two techniques in stages to optimize postoperative airway management. RALE scoring is an ideal tool for dynamic monitoring of pulmonary complications after cardiac surgery.
