Upper Extremity Elevation and Lungfunction After Open Heart Surgery

Study Overview
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Brief Summary
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The purpose of this study is to assess if arm elevation, with or without simultaneous deep breathing, affects oxygen saturation and lung function on patients two to four days after open heart surgery.

Detailed Description
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This single center, interventional crossover study will involve patients day 2, 3 or 4 after open heart surgery. Patients who meet the eligibility requirements will be informed about the study and potential risks, given a written informed consent they will be included for intervention being held later on the same day. Randomization will be given to the investigator in a sealed envelope and being opened after base line measurements. Data will then be collected for the randomized intervention and after a wash out period (several minutes) again for the crossover intervention.

Official Title
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Effects of Upper Extremity Elevation and Deep Breathing on Oxygen Saturation and Lung Volume Two to Four Days After Open Heart Surgery

Conditions
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Heart Diseases, Heart Diseases, Ischemic, Heart Disease, Valvular

Intervention / Treatment
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* Other: upper extremity elevation
* Other: upper extremity elevation with deep breathing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: open heart surgery at university hospital in Örebro Exclusion Criteria: not able to communicate in swedish difficulties in cooperating during measurements cognitive impairement prolonged stay at ICU (still at ICU on the day of investigation) ongoing oxygen treatment with more than 5 liter/minut (FiO > 40 %)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: upper extremity elevation<br>performing intervention A (5 repetitions of upper extremity elevation), and then crossed over to intervention B (5 repetitions of upper extremity with deep breathing). | Other: upper extremity elevation<br>* 5 repetitions of active upper extremity elevation in a sitting position<br>Other: upper extremity elevation with deep breathing<br>* 5 repetitions of active upper extremity elevation with deep breathing in a sitting position<br>|
| Experimental: upper extremity elevation with deep breathing<br>performing intervention B (5 repetitions of upper extremity with deep breathing), and then crossed over to intervention A (5 repetitions of upper extremity elevation). | Other: upper extremity elevation<br>* 5 repetitions of active upper extremity elevation in a sitting position<br>Other: upper extremity elevation with deep breathing<br>* 5 repetitions of active upper extremity elevation with deep breathing in a sitting position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| peripheral oxygen saturation |  | 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| tidal volume |  | 30 minutes | 
| heart rate |  | 30 minutes | 
| respiratory rate |  | 30 minutes | 
| pain - numeric rating scale | Pain (sternal, thorax or overall pain) will be measured before and after intervention, NRS will be used (patient rating of perceived pain with a score from 0 to 10) | 30 minutes | 
| dyspnea - numeric rating scale | Dyspnea will be measured before and after intervention, NRS will be used (patient rating of perceived dyspnea with a score from 0 to 10) | 30 minutes | 
| exertion - numeric rating scale | exertion will be measured before and after intervention, NRS will be used (patient rating of perceived exertion with a score from 0 to 10) | 30 minutes |