Research Article Open Access Journal of Perioperative Medicine J o u r n a l o f P e r i o p e r a t i v e M e d i c i n e Abd El- Kader and Ashmawy, J Perioper Med 2017, 1:1 Volume 1 • Issue 1 • 1000104 J Perioper Med, an open access journal Keywords: Coronary artery bypass graf surgery; Incentive spirometry; Continuous positive airway pressure breathing Introduction Ischemic heart disease continues to be one of the most common chronic illnesses in most of the developed world [1,2]. Te surgical treatment for coronary artery disease has become increasingly sophisticated in the past two decades with an expected mortality extremely low [3]. Coronary artery bypass graf (CABG) has a main beneft for relief of symptoms and increase survival rate for patients with coronary artery disease [4]. Te annual number of CABG surgeries is declining in the United States [5]. While the burden of comorbidities is increasing, the rates of mortality and most in-hospital complications are improving [6]. Te increasing rate of postoperative bleeding necessitates the need to develop strategies to improve the risk of bleeding in this patient population [7]. However, postoperative hypoxemia can be resulted from ventilation-perfusion mismatching due to inadequate transport and delivery of oxygen to the tissues or heart lung machine which cause blood loss and destruction of the blood elements [8,9]. Inspiratory muscle training is primarily used as pre-operative preparation in high-pulmonary-risk patients to reduce the incidence of post-operative pulmonary complications [10-12]. However, incentive spirometry (IS) is the most widely prescribed procedure for postoperative patients that emphasize infation to increase lung volume and maintain patency of small airways by active recruitment of respiratory muscles [13]. In addition, patients who are at post-operative pulmonary complications risk can beneft from being taught the use of IS during preoperative teaching to promote better infation of the *Corresponding author: Shehab M Abd El- Kader, Department of Physical Therapy for Cardiopulmonary Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Egypt, Tel: +966-569849276; E-mail: profshehab@live.com Received: November 27, 2017; Accepted: November 30, 2017; Published: December 04, 2017 Citation: Abd El- Kader SM, Ashmawy EM (2017) Arterial Blood Gases Response to Incentive Spirometry Versus Continuous Positive Airway Pressure breathing After Coronary Artery Bypass Graft Surgery. J Perioper Med 1: 104. Copyright: © 2017 Abd El- Kader SM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Arterial Blood Gases Response to Incentive Spirometry Versus Continuous Positive Airway Pressure breathing After Coronary Artery Bypass Graft Surgery Shehab M Abd El- Kader 1 * and Eman M Ashmawy 2 1 Department of Physical Therapy for Cardiopulmonary Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Egypt 2 Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia Abstract Background: Postoperative respiratory complications such as hypoxemia and atelectasis remain important causes of mortality after CABG. Objective: The aim of this study was to compare the changes in arterial blood gases after the use of incentive spirometry (IS) with continuous positive airway pressure (CPAP) during intensive care unit period, after coronary artery bypass graft (CABG) also to provide an idea about which of them is more effective method following coronary artery bypass surgery in intensive care unit. Methods: 30 volunteer patients’ (22 males and 8 females) who had coronary artery bypass surgery participated in this study and they were randomly selected from surgical department at intensive care unit (ICU) in National Heart Institute, Egypt, their ages ranged from 45 to 55 years. Participants were randomly assigned between two equal groups. Group 1 received incentive spirometry breathing training in addition to routine chest physiotherapy following CABG, while Group 2 received CPAP in addition to routine chest physiotherapy program following CABG. Results: The results obtained in this study indicated that, there was statistical signifcant increase PaO 2 and decrease in PaCO 2 after two hours of using incentive spirometry, which indicated long term effect of incentive spirometry. While there was no statistical signifcant improvement in arterial blood gases after two hours of using CPAP which indicated short term effect of CPAP (p<0.05). Conclusion: Incentive spirometry is superior to continuous positive airway pressure breathing to long term improve arterial blood gases following coronary artery bypass graft surgery. lung postoperatively as IS can be used independently by the patient to ensure that each inspiration is physiologically optimal [14]. While, continuous positive airway pressure (CPAP) can provide an alternative and preferable form of treatment afer CABG to avoid endotracheal intubations and its associated complications [15]. Moreover, many investigators showed that CPAP improves oxygenation, reduces work of breathing and improves cardiac output afer CABG [16]. Tis study was designed to compare the impact of incentive spirometry and CPAP on arterial blood gases afer CABG. Subjects 30 volunteer patients (22 males and 8 females) who had coronary artery bypass surgery participated in this study and they were randomly selected from surgical department at intensive care unit (ICU) in National Heart Institute. Teir ages ranged from 45 to 55 years. Te initial medical and laboratory data of each participant was obtained to ensure that none had previous other complications that might restrict their activity and interfere with the results of the data. Patients