Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure

The aim: to evaluate the efficacy of respiratory muscles training in the complex treatment of patients with acute decompensated heart failure. Material and methods. A prospective randomized study included 120 patients (71 men and 49 women, mean age 73,6±5,8 years) hospitalized with acute decompensat...

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Main Authors: N. T. Vatutin, A. N. Shevelyok, E. V. Sklyannaya, I. G. Linnik, A. V. Kharchenko
Format: Article
Language:Russian
Published: SINAPS LLC 2022-02-01
Series:Архивъ внутренней медицины
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Online Access:https://www.medarhive.ru/jour/article/view/1377
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author N. T. Vatutin
A. N. Shevelyok
E. V. Sklyannaya
I. G. Linnik
A. V. Kharchenko
author_facet N. T. Vatutin
A. N. Shevelyok
E. V. Sklyannaya
I. G. Linnik
A. V. Kharchenko
author_sort N. T. Vatutin
collection DOAJ
description The aim: to evaluate the efficacy of respiratory muscles training in the complex treatment of patients with acute decompensated heart failure. Material and methods. A prospective randomized study included 120 patients (71 men and 49 women, mean age 73,6±5,8 years) hospitalized with acute decompensated heart failure. The main exclusion criteria were: requirement for treatment in intensive care unit; hemodynamic instability; severe pulmonary and other concomitant pathology. After initial procedures all patients were randomized to breathing exercises performed in addition to standard therapy (main group, n=60) or to standard therapy only (control group, n=60). Patients of the main group were trained in the technique of complete yogic breathing, which consists of three successive phases: abdominal, thoracic and clavicular. The participants practiced full breathing daily at least 3 times a day for 10 minutes under the supervision of instructor. The primary endpoint of the study was the change in dyspnea according to the modified Borg scale (modified by V.Yu. Mareev) on the 7th day of treatment. Results. During treatment the severity of dyspnea decreased in both groups, more significantly in the main group (from 6 (5; 6) to 3 (2; 3) points) compared to control (from 6 (5; 6) to 4 (3; 4) points, p <0,05). Significant differences between the groups were also obtained for the secondary variables of efficacy: six-minute walk distance, heart rate and breathing rate at rest, blood oxygen saturation (p ><0,05). In patients who performed breathing exercises, body weight decreased faster (0,72±0,06 kg/day versus 0,53±0,06 kg/day, p ><0,001), although the volumes of excreted fluid did not differ between the groups. In the main group moist rales in the lungs were stopped by the sixth day of hospitalization (interquartile range of 5-7 days), and in the control group — by the eighth (interquartile range of 7-9 days), p=0,024. The duration of active diuretic phase and the average daily doses of diuretics were lower in main group compared to control (p ><0,05). During hospitalization quality of life improved in both groups, more significantly in respiratory muscles training group (p ><0,01). In-hospital mortality and the rate of transfers to the intensive care unit did not differ between groups. The average hospital stay in surviving patients was significantly shorter in main group than in control (14,2±2,5 versus 17,3±2,9 days, p ><0,001). >Conclusion. Respiratory muscles training with full yogic breathing in addition to standard medical therapy for patients with acute decompensated heart failure leads to a more significant reduction in the severity dyspnea, increased exercise tolerance, improved blood oxygen saturation, and reduced need for diuretics. The use of full breathing is associated with significant improvement in the quality of life and decrease in the length of hospital stay, but does not lead to improvement in hospital outcomes.
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spelling doaj-art-b6a3141a7eb448e09d85053ac0aacbb62025-08-20T04:00:01ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642022-02-01121627110.20514/2226-6704-2022-12-1-62-71879Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart FailureN. T. Vatutin0A. N. Shevelyok1E. V. Sklyannaya2I. G. Linnik3A. V. Kharchenko4GOU VPO «M. Gorky Donetsk National Medical University», department of hospital therapy; V. K. Gusak Institute of Urgent and Reconstructive SurgeryGOU VPO «M. Gorky Donetsk National Medical University», department of hospital therapy; V. K. Gusak Institute of Urgent and Reconstructive SurgeryGOU VPO «M. Gorky Donetsk National Medical University», department of hospital therapy; V. K. Gusak Institute of Urgent and Reconstructive SurgeryGOU VPO «M. Gorky Donetsk National Medical University», department of hospital therapyGOU VPO «M. Gorky Donetsk National Medical University», department of hospital therapyThe aim: to evaluate the efficacy of respiratory muscles training in the complex treatment of patients with acute decompensated heart failure. Material and methods. A prospective randomized study included 120 patients (71 men and 49 women, mean age 73,6±5,8 years) hospitalized with acute decompensated heart failure. The main exclusion criteria were: requirement for treatment in intensive care unit; hemodynamic instability; severe pulmonary and other concomitant pathology. After initial procedures all patients were randomized to breathing exercises performed in addition to standard therapy (main group, n=60) or to standard therapy only (control group, n=60). Patients of the main group were trained in the technique of complete yogic breathing, which consists of three successive phases: abdominal, thoracic and clavicular. The participants practiced full breathing daily at least 3 times a day for 10 minutes under the supervision of instructor. The primary endpoint of the study was the change in dyspnea according to the modified Borg scale (modified by V.Yu. Mareev) on the 7th day of treatment. Results. During treatment the severity of dyspnea decreased in both groups, more significantly in the main group (from 6 (5; 6) to 3 (2; 3) points) compared to control (from 6 (5; 6) to 4 (3; 4) points, p <0,05). Significant differences between the groups were also obtained for the secondary variables of efficacy: six-minute walk distance, heart rate and breathing rate at rest, blood oxygen saturation (p ><0,05). In patients who performed breathing exercises, body weight decreased faster (0,72±0,06 kg/day versus 0,53±0,06 kg/day, p ><0,001), although the volumes of excreted fluid did not differ between the groups. In the main group moist rales in the lungs were stopped by the sixth day of hospitalization (interquartile range of 5-7 days), and in the control group — by the eighth (interquartile range of 7-9 days), p=0,024. The duration of active diuretic phase and the average daily doses of diuretics were lower in main group compared to control (p ><0,05). During hospitalization quality of life improved in both groups, more significantly in respiratory muscles training group (p ><0,01). In-hospital mortality and the rate of transfers to the intensive care unit did not differ between groups. The average hospital stay in surviving patients was significantly shorter in main group than in control (14,2±2,5 versus 17,3±2,9 days, p ><0,001). >Conclusion. Respiratory muscles training with full yogic breathing in addition to standard medical therapy for patients with acute decompensated heart failure leads to a more significant reduction in the severity dyspnea, increased exercise tolerance, improved blood oxygen saturation, and reduced need for diuretics. The use of full breathing is associated with significant improvement in the quality of life and decrease in the length of hospital stay, but does not lead to improvement in hospital outcomes.https://www.medarhive.ru/jour/article/view/1377chronic heart failuredecompensationfull yogic breathingdyspneaquality of lifediureticsduration of hospitalizationmortality
spellingShingle N. T. Vatutin
A. N. Shevelyok
E. V. Sklyannaya
I. G. Linnik
A. V. Kharchenko
Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
Архивъ внутренней медицины
chronic heart failure
decompensation
full yogic breathing
dyspnea
quality of life
diuretics
duration of hospitalization
mortality
title Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
title_full Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
title_fullStr Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
title_full_unstemmed Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
title_short Respiratory Muscles Training in the Complex Treatment of Patients with Acute Decompensated Heart Failure
title_sort respiratory muscles training in the complex treatment of patients with acute decompensated heart failure
topic chronic heart failure
decompensation
full yogic breathing
dyspnea
quality of life
diuretics
duration of hospitalization
mortality
url https://www.medarhive.ru/jour/article/view/1377
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