Immediate Effect of Incentive Spirometer, Breathing Exercise and Active Cycle of Breathing Technique in CABG Patients: A Narrative Review

Background: Coronary artery bypass surgery is one of the widely used treatment as every year more than 1 million coronary artery bypass surgery procedure are performed around the world. The patients who have CABG are prone to pulmonary complications. Pulmonary complications are highly common after the CABG and the incidence is between 30% and 60%. These complications are the most significant contributor to morbidity, mortality and expenses associated with the hospitalization. Development of pulmonary complication is associated with impaired oxygenation and inconsistencies in gas exchange. Respiratory physiotherapy plays a vital role in postoperative CABG status. The interventions such as postoperative breathing exercises, effective coughing techniques, incentive spirometer and active cycle of breathing technique are used to limit lung volume decreases and atelectasis and to increase oxygenation after surgery. Objective: To find out the immediate effect of incentive spirometer, breathing exercise and active cycle of breathing technique on respiratory parameters and postoperative pulmonary complications in CABG patients. Study selection: This narrative review is conducted on databases from Pub med, Google scholar, ResearchGate and Cochrane library in Nov 2022. This review included 10 studies on the effect of incentive spirometer, breathing exercise and active cycle of breathing technique after CABG. Conclusion: It is concluded that incentive spirometer, breathing exercise and active cycle of breathing technique are effective in reducing postoperative pulmonary complications. But there are less studies which compares the two different type of  spirometer i.e. flow incentive spirometer and volume incentive spirometer in CABG patients and also there is no specific treatment protocol  for CABG patients. Hence, in order to establish a definitive protocol in patients with CABG, there is need to compare the effect of flow incentive spirometer and volume incentive spirometer along with breathing exercise and active cycle of breathing technique.