[Respiratory Muscle Training Using the Innovative TriBURTER Device in Patients Undergoing Cardiovascular Surgery: A...

Respiratory muscle weakness is common after cardiac surgery and may impair recovery. Although respiratory muscle training has demonstrated benefits, evidence during phase II cardiac rehabilitation remains limited, and many available devices are unidirectional and costly. TriBURTER® is a device that enables bidirectional respiratory muscle training.

To evaluate the feasibility, safety, and explore the potential effect of the TriBURTER® device compared with flow incentive spirometry in patients undergoing phase II cardiac rehabilitation after cardiac surgery.

This was a pilot, randomized, open-label, parallel study. Adults who had undergone cardiac surgery via sternotomy were included. Participants were assigned to training with TriBURTER® or flow incentive spirometry for 4 weeks. The primary outcome was respiratory muscle strength assessed by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Secondary outcomes included pulmonary function (FEV₁, FVC), functional capacity assessed by the six-minute walk test (6MWT), and quality of life (SF-36).

Thirty patients were randomized (mean age 61.7±9.4 years; 13.3% women). No between-group differences in MIP or MEP were observed in the overall analysis. In exploratory subgroup analyses, patients with baseline respiratory muscle weakness showed greater increases in MIP (-68 to -93cmH₂O) and MEP (93 to 116cmH₂O) in the TriBURTER® group. In intragroup analyses, 6MWT distance increased; however, no between-group differences were observed after adjustment. No adverse events were reported.

In this pilot study, TriBURTER® was safe and feasible to implement. The findings suggest a potential effect on respiratory muscle strength in exploratory analyses, particularly in patients with baseline weakness; these results require confirmation in larger, adequately powered trials.