An Evaluation of Postoperative Respiratory Maneuvers

Ward, Richard J.; Danziger, Fred; Bonica, John J.; Allen, Gerald D.; Bowes, John E.

doi:10.1097/00132586-196704000-00048

Cited by 10 publications

(13 citation statements)

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“…WARD et al [22] studied some of the effects of deep breathing: a single deep breath, a deep breath held for 5 s and multiple deep breaths. They concluded that a deep breath that is held is the most efficient way of reducing atelectasis.…”

Section: Postural Drainage and Breathing Exercisesmentioning

confidence: 99%

Physiotherapy for airway clearance in adults

1999

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Techniques for augmenting, when necessary, the normal mucociliary and cough clearance mechanisms of the lungs are not new, but, in more recent years, techniques have been developed which are effective, comfortable and can be used independent of an assistant in the majority of adolescents and adults.Postural drainage with chest clapping and chest shaking has, in most parts of the world, been replaced by the more effective techniques of the active cycle of breathing, autogenic drainage, R-C Cornet1, Flutter1, positive expiratory pressure mask, highfrequency chest wall oscillation and intrapulmonary percussive ventilation. Glossopharyngeal breathing is being considered again and is often a useful technique for increasing the effectiveness of cough in patients with tetraplegia or neuromuscular disorders.The evidence in support of these techniques is variable, and the literature is confusing and conflicting. There may or may not be significant differences among the techniques in the short or long term. Many of the regimens now include the forced expiratory manoeuvre of a "huff" and this has probably increased the effectiveness of airway clearance. If objective differences are small, individual preferences and cultural influences may be significant in increasing adherence to treatment and in the selection of an appropriate regimen or regimens for an individual patient.

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Section: Postural Drainage and Breathing Exercisesmentioning

confidence: 99%

Physiotherapy for airway clearance in adults

1999

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“…Incentive spirometry is designed to mimic natural sighing or yawning, by prompting the user to take long, slow, deep breaths. [1][2][3][4] The maneuver decreases pleural pressure, increases transpulmonary pressure, and increases inspiratory volumes, promoting lung expansion. Incentive spirometry is widely accepted as a safe procedure, and has been studied specifically in patients who have undergone both upper and lower abdominal surgery, as well as thoracic surgery.…”

Section: Introductionmentioning

confidence: 99%

Pneumothorax Caused by Aggressive Use of an Incentive Spirometer in a Patient With Emphysema

Kenny

Kuschner

2012

Respir Care

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A 68-year-old man presented to the emergency department with a small pneumothorax following aggressive use of an incentive spirometer. The patient had a baseline chest radiograph consistent with emphysema. He was initially treated with oxygen in the emergency department, with resolution of his symptoms. The pneumothorax resolved spontaneously over a period of 3 days. The development of the pneumothorax was likely due to the patient's repeated forceful inspiratory maneuvers in the setting of emphysema and lung hyperinflation. Inspiratory resistive breathing can cause large negative swings in intrathoracic pressure, which may result in mechanical stress of lung tissue. This is the first report of a secondary pneumothorax associated with use of an incentive spirometer. Patients with bullous emphysema should be counseled to avoid frequent high intensity maneuvers with an incentive spirometer if the potential benefits of the procedure are marginal.

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“…Maximal inspirations cause an increase in transpulmonary pressure and consequently an increase in lung volume (6,9). An endinspiratory pause maintains this increase in transpulmonary pressure and ensures alveolar stability (6,10,11).…”

Section: Introductionmentioning

confidence: 99%

Assessment of tidal volume and thoracoabdominal motion using volume and flow-oriented incentive spirometers in healthy subjects

Parreira

Tomich

Britto

et al. 2005

Braz J Med Biol Res

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The objective of the present study was to evaluate incentive spirometers using volume-(Coach and Voldyne) and flow-oriented (Triflo II and Respirex) devices. Sixteen healthy subjects, 24 ± 4 years, 62 ± 12 kg, were studied. Respiratory variables were obtained by respiratory inductive plethysmography, with subjects in a semi-reclined position (45º). Tidal volume, respiratory frequency, minute ventilation, inspiratory duty cycle, mean inspiratory flow, and thoracoabdominal motion were measured. Statistical analysis was performed with Kolmogorov-Smirnov test, t-test and ANOVA. Comparison between the Coach and Voldyne devices showed that larger values of tidal volume (1035 ± 268 vs 947 ± 268 ml, P = 0.02) and minute ventilation (9.07 ± 3.61 vs 7.49 ± 2.58 l/min, P = 0.01) were reached with Voldyne, whereas no significant differences in respiratory frequency were observed (7.85 ± 1.24 vs 8.57 ± 1.89 bpm). Comparison between floworiented devices showed larger values of inspiratory duty cycle and lower mean inspiratory flow with Triflo II (0.35 ± 0.05 vs 0.32 ± 0.05 ml/s, P = 0.00, and 531 ± 137 vs 606 ± 167 ml/s, P = 0.00, respectively). Abdominal motion was larger (P < 0.05) during the use of volumeoriented devices compared to flow-oriented devices (52 ± 11% for Coach and 50 ± 9% for Voldyne; 43 ± 13% for Triflo II and 44 ± 14% for Respirex). We observed that significantly higher tidal volume associated with low respiratory frequency was reached with Voldyne, and that there was a larger abdominal displacement with volumeoriented devices. Correspondence

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An Evaluation of Postoperative Respiratory Maneuvers

Cited by 10 publications

References 0 publications

Physiotherapy for airway clearance in adults

Physiotherapy for airway clearance in adults

Pneumothorax Caused by Aggressive Use of an Incentive Spirometer in a Patient With Emphysema

Assessment of tidal volume and thoracoabdominal motion using volume and flow-oriented incentive spirometers in healthy subjects

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