Effect of inspiratory muscle training on postoperative pulmonary complications and rehabilitation in patients undergoing cardiopulmonary bypass cardiac surgery

Ma Yanli; Jia Qianjin; Bai Yana; Chen Jing; Yuan Keru; Shang Juanjuan; Liu Lin; Liu Zhen; Xu Baoling; He Weiyi; Zhai Meng'en

doi:10.11986/j.issn.1673-873X.2025.09.18

Abstract：Objective To investigate the effect of inspiratory muscle training on postoperative pulmonary complications and rehabilitation in patients undergoing cardiopulmonary bypass(CPB)cardiac surgery.Methods From July 2023 to July 2024,110 patients who underwent CPB cardiac surgery in the Department of Cardiovascular Surgery at the First Affiliated Hospital of Air Force Medical University were enrolled and assigned,using a random number table,to a control group(n=55)and an observation group(n=55).During the perioperative period,the control group received routine perioperative re-spiratory training;the observation group received inspiratory muscle training in addition to routine respiratory training.In-terventions continued until postoperative day 14.Maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP)were measured preoperatively,on postoperative day 7,and on postoperative day 14.At the 4-week postoperative follow-up,6-minute walk distance(6MWD)and cardiopulmonary exercise test indicators(peak oxygen uptake[peak VO2],oxygen uptake at anaerobic threshold[AT],and slope of ventilatory equivalent for carbon dioxide[VE/VCO2])were measured.Pulmonary complications during the intervention period and within 4 weeks after discharge were recorded.Results Preoperatively,there were no significant differences between the two groups in MIP or MEP(P＞0.05).On postoperative day 7 and day 14,MIP in the observation group was significantly higher than in the control group(P＜0.05);there were no significant between-group differences in MEP on postoperative day 7 or day 14(P＞0.05).At the 4-week follow-up,the observation group had greater 6MWD,higher peak VO2 and AT,and lower VE/VCO2 than the control group,with all differences reaching statistical significance(P＜0.05).The incidence of postoperative pulmonary complications in the observation group was significantly lower than that in the control group(9.09％[5/55]vs.23.63％[13/55];x2=4.251,P=0.039).Conclusion Inspiratory muscle training effectively increases inspiratory muscle strength in patients undergoing CPB cardiac surgery,promotes cardiopulmonary functional recovery,and reduces the risk of postoperative pulmonary complications;it is worthy of clinical promotion.