Effect of pulmonary rehabilitation on the respiratory functions and quality of life of the patients who have undergone coronary artery by-pass graft surgery by on-pump method

Pulmonary rehabilitation is an important part of pre- and post-operative treatments for the prevention of postoperative pulmonary complications in patients undergoing surgical intervention. In this study, it was aimed to analyse the effect of the pulmonary rehabilitation program which was applied to the patients who underwent coronary artery by-pass graft surgery by on-pump method on these patients' respiratory function and quality of life. This study was designed as a randomized controlled experimental study. 50 patients who underwent CABG surgery by on-pump method in the Cardiovascular Surgery Clinic of Afyon Park-Hayat Private Hospital between the dates of August 2016 and December 2017, were included in the study. The patients participated in the study were divided into two groups; the patients who were applied pulmonary rehabilitation in the pre- and post-operative periods constituted the experimental group, while the patients who received standard care constituted the control group. The patients in the experimental group were given the training on respiratory exercises, the use of incentive spirometer, mobilization techniques and upper and lower extremity exercises in the pre-operarive period. In the post-operative period, these exercises were applied to the patients once a day by increasing their amount day by day; the illness was applied once a day. Standard nursing care was applied to the patients in the control group. When the results of the study were analyzed, male patients constituted 68% of the experimental group and 56% of the control group. The mean age of the patients was >60 years of age in both groups. 64% of the patients in the experimental group had an associated diasese while 68% of the patient in the control group had an associated diasese. 48% of the patients in the experimental group were obese while 52% of the patients in the control group were obese according to the body mass index. In the patients' respiratory function tests, there were significant decreases in all values except FEV1/FEVC value at post-operative 4th day compared to preoperative values (p<0.05). For the FEV1 and FEVC values, this decrease was lower in the experimental group than in the control group. In the 6-min walk test, it was found that the decrease in the 4th day walking distance in the department was lower in the experimental group (34.148%) than in the control group (36.682%). When the mean scores from the subscales of the SF-36 questionnaire which is used to assess health-related quality of life were analyzed, the mean scores of the physical function, physical role limitation, emotional role limitation, social functioning and pain subscales decreased while the mean scores of the mental health, and general health perception subscales increased. In this study, it was found that the better results were observed in the patients receiving pulmonary rehabilitation compared to the patients receiving standard nursing care in terms of respiratory function and quality of life among the patients who underwent coronary artery by-pass graft surgery by on-pump method. These results support that pulmonary rehabilitation in the patients undergoing coronary artery by-pass graft surgery is a supportive treatment method that can be applied in the procedure of treatment in the pre- and post-operative periods.