Back ground: Coronary Artery Bypass Grafting is a surgery to replace blocked arteries with healthy blood vessels and failure to fully evacuate a hemothorax post coronary artery bypass graft can lead to development of fibrothorax. Fibrothorax restricts the lung, and can begin as early as 1-2 weeks after the surgical procedure. Patients with fibrothorax report initial dyspnea. For mechanically ventilated patients, progressive difficulty with adequate ventilation due to restrictive lung mechanics can be seen. Aim of the study: The aim is to prove the effect of using Forced Expiratory pressure techniques with deep breathing exercises on wound drainage, decreasing length of stay in ICU, decreased time of TT insertion and improvement of Lung Compliance. Materials and methods: 40 male overweight Post Coronary Artery Bypass Grafting patients their age ranged between 55:65 years old were recruited from CardioTech open resuscitation unit were divided into two equal groups in number group A (20 patients) (study group) and group B (20 patients) (control group). Pre and Post assessment was performed for both groups in the form of percentage of change of fluid exudates from mediastinal and left intra-pleural thoracotomy tubes and percentage of change in peak cough flow. Both groups have performed 3 sessions two in the second day postoperative and one on the third day in the form of percussion, vibration, shaking, deep breathing exercises, incentive spirometer, acapella and circulatory exercises with adding 10 minutes of forced expiratory techniques for the study group. Results: showed no significant difference in both groups in fluid exudate from Mediastinal tubes where mean % of change for treatment group was 6.53% and that for control group was 5.08% with p value of 0.355 and also showed significant increase in % change in Left intra-pleural fluid level in treatment group with mean of 12.69% over control group with mean of 5.23% with p value of 0.001. Conclusion: Adding forced Expiratory Techniques to traditional physical therapy treatment may enhance wound drainage only in left Intra-pleural thoracotomy tubes and nearly has no effect on Mediastinal ones in Post CABG patient or his cough strength at all.
