Preoperative training education with incentive spirometry may reduce postoperative pulmonary complications

Abstract

Objective To assess whether preoperative incentive spirometer training would influence the development of postoperative pulmonary complications after lung resection. Methods Sixty-two lung resection patients were prospectively investigated; 17 were given an incentive spirometer preoperatively and 45 did not have an incentive spirometer preoperatively. Postoperatively, both arms exercised with an incentive spirometer. The number of repetitions per day, balls raised per repetition, correct technique of exercising, and postoperative pulmonary complications were compared between the 2 groups. Univariate binary logistic regression analysis of potential predictors of postoperative pulmonary complications led to multivariate analysis of independent predictors. Receiver operating characteristic analysis established the cutoff points of predictors. Results The group with no preoperative incentive spirometer developed more postoperative pulmonary complications than the preoperative incentive spirometer group (24.4% vs. 5.9%, respectively, p = 0.045). The preoperative incentive spirometer arm achieved more repetitions per day, balls per repetition, and correct incentive spirometer technique ( p = 0.002, p < 0.001, p = 0.034, respectively). Balls raised per repetition and repetitions per day postoperatively were identified as independent predictors of postoperative pulmonary complications ( p = 0.032 and p = 0.021, respectively). Less than 5 repetitions per day (sensitivity 93%, specificity 77%, p < 0.001) and less than 2 balls per repetition (sensitivity 93%, specificity 77%, p < 0.001) were predictive of postoperative pulmonary complications. Conclusion Preoperative incentive spirometer exposure ensured better compliance with postoperative treatment and a more accurate technique (balls raised per repetition, repetitions per day). These variables correlated with a lower postoperative pulmonary complication rate.

Preoperative Continuous Positive Airway Pressure Versus Incentive Spirometer in Morbidly Obese Patients Undergoing Bariatric Surgeries: Randomized Comparative Study

“…This result was consistent with the findings of Bilyy et al [12] . Postoperative pulmonary difficulties were more common in the group without a preoperative incentive spirometer (24.4 percent vs. 5.9 percent, respectively, p = 0.045).…”

“…There was no significant difference in P/F ratio between both groups at any time (Table 3). Regarding the postoperative hypoxia of the studied groups, it was noted in 46.2% (12) of CPAP group, and 38.5% (10) of spirometer group (p 0.575)…”

The Impact of Incentive Spirometry on Shoulder Tip Pain in Laparoscopic Cholecystectomy: A Randomized Clinical Trial

“…In fact, IS expanded the alveoli, dilated the chest, increased the diaphragm movements and finally stimulated it downwards. 13 In the present study, the results also indicated that IS could reduce CO 2 accumulation in the abdominal cavity and cause CO 2 removal. This mechanism could further moderate the severity of shoulder pain and thus decline patient-controlled analgesia with the usage frequency to relieve PLSP.…”

“…12 In fact, incentive spirometry (IS) expands the alveoli and the chest which, in turn, increases the movements of the diaphragm and stimulate it downwards. 13 This reduces the accumulation of CO 2 in the abdominal cavity and can ultimately lead to the elimination of CO 2 . IS has been introduced as an effective method in clinical practices; also, studies have provided particular instructions on how to apply it.…”

Pre-Habilitation of Cardiac Surgical Patients, Part 2: Frailty, Malnutrition, Respiratory disease, Alcohol/Smoking cessation and Depression

“…Preoperative pulmonary rehabilitation, inspiratory muscle training, and the use of incentive spirometry have been shown to decrease the incidence of postoperative pulmonary complications. 50,51 Pulmonary rehabilitation may play a role for select patients prior to cardiac surgery. Pulmonary rehabilitation may involve weekly sessions of respiratory exercises and education before planned surgery in patients with respiratory diseases.…”