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IRCT2016051527908N1 IRCT 2017-01-03 Vice chancellor for research of Shahid Rajaei Cardiovascular Medical and Research Center, Iran Univ Effect of Early mobilization of Diaphragm Muscles strength Effect of "early mobilization protocol" after cardiac surgery on rate diaphragmatic muscle strength 2016-09-22 anticipated 80 Complete https://irct.ir/trial/22769 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive. N/A coronary heart disease. Intervention 1: In intervention group: patient learns how to breathe ,then measurement of diaphragm muscle strength would be done by power breath. After surgery and emitting chip pipe patient deepens on situation ( second day after surgery) and doctor's command in first group by considering safety issues, stiller, contraindication for early mobilization by using early mobilization protocol and by physiotherapy assisting are done. At the end measuring diaphragm strength would be done before leaving ICU. Intervention 2: In control group: patient learns how to breathe ,then measurement of diaphragm muscle strength would be done by power breath. After surgery and extubation based on doctor's command , physiotherapy would be done by physiotherapist help. At the end measuring diaphragm strength would be done before leaving ICU.
public Sara Lotfian
Rajaei Cardiovascular Medical and Research Center, Vali-Asr ave., Niayesh Blvd., Tehran, Iran
Tehran Iran (Islamic Republic of) +98 21 2392 2489 saralotfiyan@yahoo.com Rajaei Cardiovascular Medical and Research Center scientific Sara Lotfian
Rajaei Cardiovascular Medical and Research Center, Vali-Asr ave., Niayesh Blvd., Tehran, Iran
Tehran Iran (Islamic Republic of) +98 21 2392 2489 saralotfiyan@yahoo.com Rajaei Cardiovascular Medical and Research Center Iran (Islamic Republic of) Inclusion criteria: Age of participants must be 20-65 years old; The surgery must be elective; The participants must not be so sleepy and agitated ( RASS between -2 and +2); The participants must not have cardiac arrhythmia; LVEF >30% Exclusion criteria: Having long-term mechanical ventilation (more than 48 hours); Difficulties in movement after surgery; Cardiac arrest during or after surgery; Disable to communicate because of neurological, visual or auditory disorders; If each contraindication happened in early mobilization ( FIO2 >85%, PEEP>15 , severe heart ischemic, uncontrolled cardiac arrhythmia, impermanent blood pressure despite receiving vasopressors, open sternumŲŒ LVEF less than 30% ) 6- Known case of pulmonary disease ( diaphragm disorder, COPD, hemothorax, pleural effusion, etc); History of thoracic surgery.; Smoking. 20 years 65 years Both I25.1 Atherosclerotic heart disease Coronary (artery): atheroma atherosclerosis disease sclerosis Rehabilitation Rehabilitation In intervention group: patient learns how to breathe ,then measurement of diaphragm muscle strength would be done by power breath. After surgery and emitting chip pipe patient deepens on situation ( second day after surgery) and doctor's command in first group by considering safety issues, stiller, contraindication for early mobilization by using early mobilization protocol and by physiotherapy assisting are done. At the end measuring diaphragm strength would be done before leaving ICU. In control group: patient learns how to breathe ,then measurement of diaphragm muscle strength would be done by power breath. After surgery and extubation based on doctor's command , physiotherapy would be done by physiotherapist help. At the end measuring diaphragm strength would be done before leaving ICU. PIMAX: maximum pressure that patient must overcome it to bring more air into lung. SINDEX: quality criterion for measuring the breathing muscle power which is based on comparison by the amounts of same normal age, gender, height and weight. Timepoint: patient before surgury and afther surgury and both tow group. Method of measurement: Collecting data tools for this study is power breath device which its producer is KS POWER made in England. Heart rate. Timepoint: before and during admission in ICU. Method of measurement: monitoring. Oxygen saturation. Timepoint: before and during admission in ICU. Method of measurement: monitoring. Blood pressure. Timepoint: before and during admission in ICU. Method of measurement: monitoring. Number of days admitted to ICU. Timepoint: during admission in ICU. Method of measurement: nursing report. Number of stages done in early mobilization protocol. Timepoint: during admission in ICU. Method of measurement: observation by researcher. Respiratory rate. Timepoint: before and during admission in ICU. Method of measurement: monitoring. Vice chancellor for research of Shahid Rajaei Cardiovascular Medical and Research Center, Iran Univ Approved 2016-08-06 Tehran ,Shahid RajaeeCardiovascular Educational,Researching and clinical institute Rajaei Cardiovascular Medical and Research Center, Vali-Asr ave., Niayesh Blvd., Tehran, Iran Tehran Iran (Islamic Republic of)