1. Deep breathing exercises for cardiac surgery patients after discharge - a randomized controlled trial PhD, RPT Elisabeth Westerdahl Urell C, Jonsson M, Bryngelsson I, Hedenström H, Emtner M. Örebro University Hospital, Uppsala University and Örebro University, Sweden. elisabeth.westerdahl@orebroll.se

2. Quick topic overview Physical therapy instructions for postoperative breathing exercises after cardiac surgery vary in clinical practice. In this two-center, single-blind RCT the effects of home-based deep breathing exercises performed two months following cardiac surgery was compared to a control group performing no breathing exercises after discharge.

3. Intervention Breathing exercises: 30 breaths with a PEP-device (10-15 cmH 2 O) performed 5 times/day during 2 months. Control group: No breathing exercises after discharge

4. Outcome measures SpO 2 Spirometry (VC, FVC, FEV1, FEV1/VC, IC, FRC, RV, TLC) Subjective experiences Patient-perceived quality of recovery (QoR-40) Health-related quality of life (SF-36) Respiratory tract infection/pneumonia Antibiotic treatment Surgical data Breathing group (n = 159) Control group (n =154) CABG / valve / CABG + valve52 / 77 / 3054 / 76 / 24 Operation time, h 4  1 ECC time, min 112  49115  52 AoO time, min 79  3980  41 Postoperative mechanical ventilation, h6  46  3

5. Conclusions Two months postoperatively, the patients had: Significantly reduced lung function FEV 1 93 ± 12 % (p <0.001) of preoperative values. Peripheral oxygen saturation had returned to preoperative values. Health-related quality of life was improved compared to preoperative values (p<0.01). There were no significant differences between the groups in any of the measured outcomes.