Impact Of Positive End Expiratory Pressure Device On Maximum Expiratory Pressure, Maximum Voluntary Ventilation And Dyspnea Index In Patients After Valvular Heart Surgery: Randomized Controlled Trial

Abstract

Background

Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults globally In Egypt, the prevalence of RHD is still high and the use of devices and prosthetic materials is increasing dramatically.

So this experiment was conducted to investigate the efficacy of PEEP device on respiratory muscle strength in patients who underwent valve surgery.

 Methods

 Evaluation Procedure

1- Measurement of MEP: This is the most widely used noninvasive method in the clinic for evaluation of respiratory muscle strength (RMS) ¹³.

Steps of measuring: Respiratory pressure meter device:

CareFusion UK 232 Ltd, ME4 4QY.UK, SN: (064-02857) used to measure MEP.

1-The device is at zero and calibrated before each measurement.

2- The patient maximally exhales from TLC. Nose clips are required. The patient is coached to ensure adequate lip seal around the mouthpiece and achieve maximum voluntary effort, and the effort is repeated until at least three measurements have <20% variability between them. The highest mouth pressure achieved which could be maintained for at least 1 sec was collected for data processing.

 Conclusion

Patients who underwent valvular heart surgery exhibited reductions in postoperative respiratory muscle strength and lung function. So it is advisable to add expiratory training using PEEP device with mouthpiece to routine chest physiotherapy for those patients after valvular heart surgery.