Abstract
Background Postoperative respiratory dysfunction remains a clinically significant problem after cardiac surgery. However, clinical evidence on vibroacoustic pulmonary therapy in adult cardiac surgery patients remains limited. The study aimed to compare early postoperative oxygenation following vibroacoustic pulmonary therapy using VibroLUNG with routine manual chest physiotherapy after cardiac surgery. Methods This prospective, multicentre, observational, non-randomized comparative study included adult patients aged 18–80 years who underwent elective cardiac surgery and developed postoperative respiratory dysfunction meeting the study eligibility criteria. Group allocation reflected routine clinical practice and device availability at the participating centers. Patients received either vibroacoustic pulmonary therapy using VibroLUNG or routine manual percussion chest physiotherapy. The principal respiratory outcome analysed in this manuscript was the P/F ratio at the early postoperative assessment. Key secondary outcomes included FiO₂ requirement, SpO₂, PaO₂, PaCO₂, acid–base status parameters, clinical scales, radiographic findings, length of stay, and recorded safety outcomes. Results Of 354 screened patients, 317 were included in the analysis: 156 in the VibroLUNG group and 161 in the control group. Baseline anthropometric characteristics were comparable; however, the distribution by center/region differed substantially between the groups. At the early postoperative assessment, the VibroLUNG group had a lower administered FiO₂ [35.0% [30.0–41.0] vs. 41.5% [40.0–50.0], p < 0.001]. In the principal centre-adjusted analysis, the P/F ratio was higher in the VibroLUNG group by 23.8 units (95% CI 8.1–39.5; p =0.003). Before extubation, FiO₂ remained lower in the VibroLUNG group [30.0% [30.0–35.0] vs. 35.0% [30.0–50.0], p < 0.001], whereas the unadjusted difference in the P/F ratio was not statistically significant. No device-related adverse events, device deficiencies, or deaths during study participation were recorded. Conclusion VibroLUNG use was associated with a higher early postoperative P/F ratio and lower administered FiO₂. No adverse events, device deficiencies, or deaths were recorded during the study observation period. Causal inference is limited by the non-randomized design and centre-level differences.