Christos Tsagkaris

Conference 2022 Poster Presentation

Project title

Efficacy of Early and Enhanced Respiratory Physiotherapy and Mobilization after On-Pump Cardiac Surgery: A Prospective Randomized Controlled Trial

Authors and Affiliations

Georgios Afxonidis1, Dimitrios V. Moysidis2,3, Andreas S. Papazoglou 3,4, Christos Tsagkaris5,6, Anna Loudovikou3,6, Georgios Tagarakis2,3, Georgios T. Karapanagiotidis 2,3, Ioannis A. Alexiou2,3, Christophoros Foroulis2,3 and Kyriakos Anastasiadis2,3

1. Cardiothoracic Surgery Department, General University Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece
2. Cardiothoracic Surgery Department, AHEPA University Hospital, 53636 Thessaloniki, Greece
3. School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
4. Athens Naval Hospital, 15561 Athens, Greece
5. School of Medicine, Faculty of Health Sciences, University of Crete, 71003 Heraklion, Greece
6. European Student Think Tank, Public Health and Policy Working Group, 1058 Amsterdam, The Netherlands



This randomized controlled trial aimed to investigate the influence of physical activity and respiratory physiotherapy on zero postoperative day on clinical, hemodynamic and respiratory parameters of patients undergoing cardiac surgeries under extracorporeal circulation.


78 patients undergoing coronary artery bypass graft (CABG) or/and valvular heart disease surgeries were randomly assigned into an early and enhanced physiotherapy care group (EEPC group; n = 39) and a conventional physiotherapy care group (CPC group; n = 39). Treatment protocol for the EEPC group included ≤3 Mets of physical activity and respiratory physiotherapy on zero post-operative day and an extra physiotherapy session during the first three post-operative days, whereas the CPC group was treated with usual physiotherapy care after the first post-operative day. The length of hospital and intensive care unit (ICU) stay were set as the primary study outcomes, while pre- and post-intervention measurements were also performed to assess the oxymetric and hemodynamic influence of early mobilization and physiotherapy.


Participants’ mean age was 51.9 ± 13.8 years. Of them 48 (61.5%) underwent CABG. Baseline and peri-procedural characteristics did not differ between the two groups. The total duration of hospital and ICU stay were significantly higher in the CPC group compared to the EEPC group (8.1 ± 0.4 days versus 8.9 ± 0.6 days and 25.4 ± 3 h versus 23.2 ± 0.6 h, p < 0.001, respectively). Statistically significant differences in pre-intervention oxygen saturation, and post-intervention PO2 and lactate levels were also observed between the two groups (p = 0.022, 0.027 and 0.001, respectively).


In on-pump cardiac surgery, early and enhanced post-procedural physical activity (≤3 METS) can prevent a prolonged ICU stay and decrease the duration of hospitalization while ameliorating post-operative hemodynamic and oxymetric parameters.