Effect of Coughing Exercises Versus Incentive Spirometry on Respiratory Function and Recovery in Children After Cardiac Surgery. (CEXIS)

University of Baghdad

Status: Enrolling

Conditions: Postoperative Recovery After Cardiac Surgery; Congenital Heart Disease (CHD); Postoperative Respiratory Dysfunction

Treatments: Device: Incentive Spirometry; Behavioral: Coughing Exercises; Other: Standard Postoperative Care

Study type: Interventional

Funder types: Other

Identifiers

NCT07405333

UOB-NUR-2026-01

Details and patient eligibility

About

This study examines the effects of coughing exercises and incentive spirometry (IS) on lung function and recovery in children who undergo heart surgery. The main goals are to see:

How coughing exercises and IS affect breathing and lung function after surgery? How these exercises influence overall recovery after surgery? Children who participate will be randomly assigned to one of three groups: coughing exercises, IS, or standard care. Those in the exercise groups will perform their assigned breathing exercises every 3 hours for the first 3 days after surgery. Daily check-ups will be conducted to monitor their progress, lung function, and oxygen levels.

The study will measure breathing ability, oxygen levels, and recovery milestones to find out which method is most effective in preventing lung complications and helping children recover faster.

Full description

This clinical trial evaluates the effects of coughing exercises and incentive spirometry (IS) on postoperative respiratory outcomes and recovery in children undergoing elective cardiac surgery with cardiopulmonary bypass.

The study aims to answer:

How do coughing exercises and IS influence lung function and breathing after surgery? How do they affect overall recovery, including physical comfort, oxygenation, and prevention of pulmonary complications?

Eligible children aged 6 to 18 years will be randomly assigned to one of three groups:

Coughing exercises group Incentive spirometry group Standard care group Children in the intervention groups will perform the assigned exercises every 3 hours for the first 3 days after surgery. All participants will receive daily monitoring, including vital signs, oxygen saturation, lung function assessment, and observation of postoperative recovery indicators such as feeding tolerance and mobility.

The study will assess primary outcomes such as postoperative respiratory function using a standardized respiratory score, and secondary outcomes including postoperative recovery indicators (quality of recovery scores), incidence of pulmonary complications, and length of stay in the pediatric intensive care unit (ICU).

This research will help identify the most effective method for improving respiratory outcomes, reducing complications, and supporting faster recovery in children after cardiac surgery.

Enrollment: 99 estimated patients

Sex: All

Ages: 6 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Crit

• Children aged 6 to 18 years scheduled for elective cardiac surgery.
• Postoperative extubation within 24 hours and judged clinically stable to begin respiratory therapy.
• Hemodynamically stable.

Exclusion Criteria:

• Pre-existing moderate-to-severe chronic lung disease requiring baseline oxygen therapy.
• Neuromuscular disorders significantly impairing cough/inspiratory effort.
• Emergency surgery, ongoing major bleeding.
• Prolonged mechanical ventilation >72 hours or tracheostomy on admission.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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99 participants in 3 patient groups

Coughing Exercises

Experimental group

Description:

participants in this arm will receive structured postoperative coughing exercises under professional supervision. The exercises include deep breathing followed by effective coughing techniques to enhance airway clearance, promote lung expansion, and prevent postoperative pulmonary complications. The intervention will be performed every 3 hours for three days after cardiac surgery in addition to standard postoperative care.

Treatment:

Behavioral: Coughing Exercises

Incentive Spirometry (IS)

Experimental group

Description:

Participants in this arm will receive postoperative incentive spirometry under professional supervision. Children will be instructed to perform slow, deep inhalations using an incentive spirometer to promote lung expansion, improve ventilation. The intervention will be performed 15 times every 3 hours for three days after cardiac surgery in addition to standard postoperative care.

Treatment:

Device: Incentive Spirometry

Standard Postoperative Care

Active Comparator group

Description:

Participants in this arm will receive standard postoperative care following cardiac surgery without additional structured respiratory physiotherapy interventions. Standard care includes routine medical and nursing management according to hospital protocols, such as oxygen therapy, pain management, monitoring of vital signs, and general postoperative mobilization as tolerated.

Treatment:

Other: Standard Postoperative Care