Evidence map›Paper›PMID 41668083›Full record

Trial reportBMC surgery2026

Effects of combined Triflow, deep breathing and coughing exercises on postoperative pulmonary function after mitral valve replacement: a randomized controlled trial.

Naile Akıncı, Esra Eren

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06997224 (Comparison of the Effects of Triflow and Deep Breathing and Cough Exercises on Postoperative Respiratory Functions in Patients Undergoing Mitral Valve Replacement), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06997224 narecruitingnot on this map

Comparison of the Effects of Triflow and Deep Breathing and Cough Exercises on Postoperative Respiratory Functions in Patients Undergoing Mitral Valve Replacement: A Randomized Controlled Trial

TypeinterventionalSponsorAtlas UniversityRan2025 to 2025Enrolled60ConditionsMitral Valve Failure, SurgeryArmstriflow application
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Naile AkıncıDepartment of Nursing, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey. naileaksit@gmail.com.ORCID http://orcid.org/0000-0002-7328-8610
Esra ErenDepartment of Nursing, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.ORCID http://orcid.org/0000-0001-5036-9322

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement.

methodsThis randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone.

resultsPostoperative SpO₂ levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV₁/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group.

conclusionThe combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.

trial registrationClinicalTrials.gov Identifier NCT06997224 (First registered on 15 May 2025).

Indexed as

Breathing ExercisesExercise TherapyHeart Valve Prosthesis ImplantationMitral ValvePostoperative ComplicationsAdultAgedCoughFemaleHumansMaleMiddle AgedSingle-Blind MethodSpirometryBreathing exercisesMitral valve replacementPostoperative complicationsPulmonary function

Identifiers

PMID41668083
PMCPMC12937576

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.