[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100638373":3},{"organization":4,"armGroups":7,"interventions":28,"overallOfficials":39,"centralContacts":49,"locations":55,"responsibleParty":73,"collaborators":12,"id":77,"slug":78,"hasResults":79,"nctId":80,"briefTitle":81,"officialTitle":82,"acronym":83,"eligibilityCriteria":84,"healthyVolunteers":79,"sex":85,"minAge":86,"maxAge":87,"enrollmentInfo":88,"targetDuration":12,"studyType":91,"phases":92,"briefSummary":94,"conditions":95,"keywords":100,"overallStatus":109,"whyStopped":12,"lastUpdateSubmitDate":110,"lastUpdatePostDateStruct":111,"startDateStruct":114,"completionDateStruct":116,"leadSponsor":118,"locationsCount":119},{"fullName":5,"class":6},"Assiut University","OTHER",[8,13,19,24],{"label":9,"type":10,"description":11,"interventionNames":12},"Arm 1: Control Group","NO_INTERVENTION","Participants in this group will receive only the standard, routine postoperative hospital care protocols implemented by the cardiothoracic care unit. No structured positioning maneuvers or Active Cycle of Breathing Techniques (ACBT) will be provided by the researcher",null,{"label":14,"type":15,"description":16,"interventionNames":17},"Arm 2: ACBT Only Group","EXPERIMENTAL","Participants will perform the Active Cycle of Breathing Techniques (ACBT), which includes breathing control, thoracic expansion exercises, and huffing (forced expiration technique). Once the patient is hemodynamically stable on postoperative day 1 (POD 1), the technique will be applied in cycles and performed three times daily for 10-15 minutes over 5 postoperative days.",[18],"Behavioral: Active Cycle of Breathing Techniques (ACBT)",{"label":20,"type":15,"description":21,"interventionNames":22},"Arm 3: Positioning Only Group","Participants will receive structured position management exclusively. In the early postoperative phase (0-6 hours or until extubation), patients are managed with head elevation at 30-45 degree and turning the head to one side. Post-extubation\u002Fafter 6 hours, patients will be placed in a semi-recumbent position ($\\\\approx60\\^{\\\\circ}$) during waking hours and 15-30 degree during sleep, with additional advanced positions (forward-leaning, postural drainage, and prone positioning) integrated as tolerated.",[23],"Behavioral: Structured Position Management Protocol",{"label":25,"type":15,"description":26,"interventionNames":27},"Arm 4: Combined Group (Positioning + ACBT)","Participants will receive a synchronized combination of both structured position management and the Active Cycle of Breathing Techniques (ACBT). Positioning protocols (early head elevation and semi-recumbent adjustments) will be followed by advanced position changes (lateral or forward-leaning) as tolerated. Following extubation and clinical stabilization, ACBT sessions will be initiated on the identical frequency and duration schedule as the ACBT group (three times daily for 10-15 minutes over 5 days).",[23,18],[29,34],{"type":30,"name":31,"description":32,"armGroupLabels":33,"otherNames":12},"BEHAVIORAL","Structured Position Management Protocol","A systematic nursing-driven positioning protocol designed to utilize gravitational forces to optimize lung volumes and minimize pulmonary secretions. In the early postoperative phase (0-6 hours or until extubation), patients are managed with head elevation at 30-45 and the head turned to one side. Post-extubation\u002Fafter 6 hours, patients are maintained in a semi-recumbent position (approx60during waking hours and 15-30 during sleep. Additional positions including lateral rotations, forward-leaning, postural drainage, and prone positioning are integrated throughout the stay as clinically tolerated",[20,25],{"type":30,"name":35,"description":36,"armGroupLabels":37,"otherNames":38},"Active Cycle of Breathing Techniques (ACBT)","A structured airway clearance regimen performed independently by the patient following specialized nursing instruction. The technique integrates breathing control (normal relaxed breathing), thoracic expansion exercises (deep breathing), and the forced expiration technique (huffing) to mobilize peripheral pulmonary secretions. Once the patient is clinically stable on postoperative day 1 (POD 1), the cycle is performed three times daily for 10-15 minutes, continuing across 5 postoperative days.",[14,25],[14,25],[40,44,47],{"name":41,"affiliation":42,"role":43},"Sahra Zaki Azer, Professor","Faculty of nursing-Assuit uiversity","STUDY_CHAIR",{"name":45,"affiliation":42,"role":46},"Amna Abdullah Desoky, Professor","STUDY_DIRECTOR",{"name":48,"affiliation":5,"role":46},"Mohamed Mahmoud Ahmed, Assistant Professor",[50],{"name":51,"role":52,"phone":53,"phoneExt":12,"email":54},"Mahmoud Fathi Abdelhafeez Soliman, MSc, PhD Candidate","CONTACT","+201006579808","mahmoud808@aun.edu.eg",[56],{"facility":57,"status":12,"city":58,"state":59,"zip":60,"country":61,"countryCode":62,"cosmosGeoPoint":63,"geoPoint":68,"contacts":69},"Assiut University Heart Hospital, Cardiothoracic Surgery Department","Asyut","Asyut Governorate","71515","Egypt","EG",{"type":64,"coordinates":65},"Point",[66,67],31.18368,27.18096,{"lat":67,"lon":66},[70],{"name":71,"role":52,"phone":72,"phoneExt":12,"email":54},"Mahmoud Soliman","01006579808",{"type":74,"investigatorFullName":75,"investigatorTitle":76,"investigatorAffiliation":5,"oldNameTitle":12,"oldOrganization":12},"PRINCIPAL_INVESTIGATOR","Mahmoud Fathy Abdelhafeez Soliman","Assistant lecturer","100638373","effect-of-positioning-and-acbt-on-pulmonary-complications-after-cardiac-surgery-100638373",false,"NCT07612033","Effect of Positioning and ACBT on Pulmonary Complications After Cardiac Surgery","Effect of Positioning Combined With Active Cycle of Breathing Techniques on Pulmonary Complications After Cardiac Surgeries","P-ACBT","Inclusion Criteria:\n\n* Adult patients (aged from 20 years to 65 years old).\n* Undergoing elective cardiac surgery (Coronary Artery bypass Grafting (CABG) or valves surgeries) via median sternotomy.\n* Hemodynamically stable postoperatively (no high-dose vasopressor support).\n* Fully conscious and capable of following complex verbal instructions.\n\nExclusion Criteria:\n\n* • Patients undergoing emergency cardiac surgery.\n\n  * History of chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), bronchial asthma, or bronchiectasis\n  * Pre-existing pulmonary complications (e.g., pneumonia, atelectasis, pleural effusion) prior to surgery\n  * Neuromuscular disorders affecting respiratory muscles\n  * Severe obesity (e.g., BMI ≥35 kg\u002Fm²)\n  * Cognitive impairment or inability to follow instructions\n  * Any contraindication to physiotherapy techniques (e.g., unstable sternum, severe pain not controlled)","ALL","20 Years","65 Years",{"count":89,"type":90},124,"ESTIMATED","INTERVENTIONAL",[93],"NA","The goal of this quasi-experimental clinical trial is to learn if position management combined with the Active Cycle of Breathing Techniques (ACBT) works to reduce postoperative pulmonary complications in adult patients undergoing elective cardiac surgery. It will also evaluate the individual effects of each technique compared to routine care.\n\nThe main questions it aims to answer are:\n\nDoes the combination of positioning and ACBT significantly lower the incidence and severity of postoperative pulmonary complications (like atelectasis, pneumonia, and respiratory failure) within the first 7 days after surgery? Does the combination of these techniques reduce the length of hospital stay compared to using each technique alone or routine care? Does the application of ACBT alone lower the rate of respiratory infections? Does position management alone improve oxygenation parameters (such as SpO\\_{2} and PaO\\_{2})?\n\nResearchers will compare four groups of patients to determine the most effective nursing approach:\n\nGroup 1 (Control Group): Participants will receive routine postoperative hospital care only.\n\nGroup 2 (ACBT Group): Participants will perform the Active Cycle of Breathing Techniques (breathing control, thoracic expansion, and huffing) three times daily for 10-15 minutes over 5 postoperative days.\n\nGroup 3 (Positioning Group): Participants will receive structured position management exclusively, shifting from head elevation (30-45) early after surgery to a semi-recumbent position (approx60) during waking hours, alongside other positions like lateral or forward-leaning as tolerated.\n\nGroup 4 (Combined Group): Participants will receive both structured position management and perform the ACBT sessions according to the same schedules.\n\nAll participants will undergo daily respiratory assessments using a standardized scoring system for 7 days post-surgery or until hospital discharge.",[96,97,98,99],"Postoperative Pulmonary Complications (PPCs)","Cardiac Surgery With Sternotomy","Atelectasis","Postoperative Pneumonia",[101,102,103,104,105,106,107,108],"Position management","Active Cycle of Breathing Techniques ACBT","Postoperative pulmonary complications (PPCs)","Cardiac surgery (Open heart surgery)","Median sternotomy","Respiratory rehabilitation","Atelectasis prevention","Nursing-driven intervention","NOT_YET_RECRUITING","2026-05-21",{"date":112,"type":113},"2026-05-28","ACTUAL",{"date":115,"type":90},"2026-06-15",{"date":117,"type":90},"2027-01-01",{"name":5,"class":6},1]