The Effect of Incentive Spirometry on Postoperative Pulmonary Function Following Laparotomy

Tyson, Anna F.; Kendig, Claire E.; Mabedi, Charles; Cairns, Bruce A.; Charles, Anthony

doi:10.1001/jamasurg.2014.1846

Cited by 44 publications

(33 citation statements)

References 52 publications

(66 reference statements)

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“…The CS estimate, a novel prognostic index, provides new information relevant to the dynamic prognostic changes that occur for patients with gastric cancer. Several studies have shown that CS estimates are highly significant to the evaluation of the prognostic prospects of patients with various malignant diseases [ 4 , 6 – 16 , 20 ]. Furthermore, it is generally accepted that patients with poor prognostic features at the time of initial diagnosis show, compared with those without these features, greater increases in CS over time.…”

Section: Discussionmentioning

confidence: 99%

“…Thus they account for changes in hazard rate over time as well as for dynamic changes in prognosis. The usefulness of CS estimates has been established for many solid malignancies including urothelial, colorectal, thyroid, ovary, breast, lung and gastric tumors [ 3 , 4 , 6 – 15 ]. A multicenter analysis by the US Gastric Cancer Collaborative indicated that CS estimates provided important information on changes in the probability of survival over time [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Conditional survival analysis in Korean patients with gastric cancer undergoing curative gastrectomy

et al. 2015

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BackgroundConditional survival (CS) measures the probability that patients will survive an additional number of years given that they have already survived for a certain period of time.MethodsIn total, 2935 gastric cancer patients who had undergone curative gastrectomy between 1995 and 2011 were enrolled. The Cox proportional hazard regression model was used to evaluate the factors associated with overall survival (OS). Three-year CS estimates at ‘t’ years after surgery were calculated as follows: CS(t) = S(t + 3)/S(t).ResultsThe 1-, 2-, 3-, 4- and 5-year OS rates of the 2935 patients were 96.6 %, 92.0 %, 88.7 %, 85.6 and 82.7 %, respectively. The probability of surviving an additional 3 years on the condition of having already survived 1, 2, 3, 4 and 5 years after surgery were 88.6 %, 89.9 %, 91.0 %, 92.2 % and 93.2 %, respectively. Patients with a higher risk at baseline showed a greater increase in CS over time.ConclusionsCS estimates provide important information about dynamic prognostic changes over time for Korean gastric cancer patients, and as such, can be used to guide long-term follow-up strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Conditional survival analysis in Korean patients with gastric cancer undergoing curative gastrectomy

et al. 2015

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“…In a systematic review and meta-analysis in 2012, postoperative deep breathing exercise was associated with improved pulmonary function and respiratory muscle strength after elective upper abdominal surgery – but it did not reduce the incidence of pulmonary complication[44]. A recent randomized controlled trial of 150 patients undergoing exploratory laparotomy including emergency colorectal surgery (about 45%) showed that adding incentive spirometry to a routine breathing exercise did not improve the recovery of postoperative pulmonary function nor decreased the rate of respiratory complication and length of hospital stay[45]. Although there is no evidence indicating the direct benefits of breathing exercise after emergency colorectal surgery, many surgeons still encourage their patients to have sessions of deep breathing and coughing in the early postoperative period[8].…”

Section: Application Of Eras Items In Emergency Colorectal Surgery Anmentioning

confidence: 99%

Enhanced recovery after surgery in emergency colorectal surgery: Review of literature and current practices

Lohsiriwat

Jitmungngan

2019

WJGS

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Enhanced recovery after surgery (ERAS), a multidisciplinary program designed to minimize stress response to surgery and promote the recovery of organ function, has become a standard of perioperative care for elective colorectal surgery. In an elective setting, ERAS program has consistently been shown to decrease postoperative complication, reduce length of hospital stay, shorten convalescence, and lower healthcare cost. Recently, there is emerging evidence that ERAS program can be safely and effectively applied to patients with emergency colorectal conditions such as acute colonic obstruction and intraabdominal infection. This review comprehensively covers the concept and application of ERAS program for emergency colorectal surgery. The outcomes of ERAS program for this emergency surgery are summarized as follows: (1) The ERAS program was associated with a lower rate of overall complication and shorter length of hospital stay – without increased risks of readmission, reoperation and death after emergency colorectal surgery; and (2) Compliance with an ERAS program in emergency setting appeared to be lower than that in an elective basis. Moreover, scientific evidence of each ERAS item used in emergency colorectal operation is shown. Perspectives of ERAS pathway in emergency colorectal surgery are addressed. Finally, evidence-based ERAS protocol for emergency colorectal surgery is presented.

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“…6 The underlying mechanism responsible for POPC is thought to involve a combination of decreased lung expansion causing atelectasis, diminished mucociliary clearance, and reduced respiratory muscle function, which together may promote colonization and proliferation of bacteria. 1,7 Thus, post-surgical interventions that promote mobilization 1 Department of Thoracic Surgery, Norfolk and Norwich University Hospital, UK 2 St. George's University School of Medicine, Grenada, West Indies of pulmonary secretions and alveolar expansion could potentially reduce the incidence of POPC. Incentive spirometry (IS) has been routinely used to prevent and treat POPC postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Preoperative training education with incentive spirometry may reduce postoperative pulmonary complications

Bilyy

El-Nakhal

Kadlec

et al. 2020

Asian Cardiovasc Thorac Ann

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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.

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The Effect of Incentive Spirometry on Postoperative Pulmonary Function Following Laparotomy

Abstract: clinicaltrials.gov Identifier: NCT01789177.

Cited by 44 publications

References 52 publications

Conditional survival analysis in Korean patients with gastric cancer undergoing curative gastrectomy

Conditional survival analysis in Korean patients with gastric cancer undergoing curative gastrectomy

Enhanced recovery after surgery in emergency colorectal surgery: Review of literature and current practices

Preoperative training education with incentive spirometry may reduce postoperative pulmonary complications

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