Using endotracheal tube as an adaptor to provide incentive spirometry to tracheostomised patients

Bloria, Summit Dev; Bloria, Pallavi; Luthra, Ankur; Kataria, Ketan

doi:10.4103/ija.ija_371_19

Cited by 3 publications

(4 citation statements)

References 1 publication

(2 reference statements)

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“…Notably, patients with a tracheostomy may not sustain the intrathoracic pressure since the vocal cords are bypassed by tracheostomy and this, in turn, may affect the effective use of the spirometer. This challenge arises from the fact that the tracheostomy tube bypasses the vocal cords, impacting the patient's ability to generate and sustain the necessary pressure for optimal use of the spirometer [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the current landscape of available spirometers presents limitations in their suitability for patients with tracheostomies, both in terms of physical compatibility and uncertainties regarding their effectiveness in this specific patient population [ 4 , 14 , 15 ]. This underscores the need for innovative spirometry designs or alternative respiratory interventions tailored specifically for individuals with tracheostomies to address these challenges and optimize respiratory therapy for this unique patient group [ 12 , 16 ]. Additionally, previous studies have not addressed whether such device use is effective in improving lung function after the recommended session of spirometry, which is an important outcome measure after spirometry.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Volume-Oriented Incentive Spirometry on Lung Volume and Peak Expiratory Flow Rate in Patients With Tracheostomy

Sankar Ganesh,

Abathsagayam,

Ravisankar

2024

Cureus

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Background The volume-oriented incentive spirometer is a specialized device designed to facilitate maximal inspiration, promote deep breathing exercises, and enhance lung function. The use of spirometry is challenging and not proven in patients with tracheostomy. Therefore, this study aimed to assess the impact of volume-oriented incentive spirometry on lung volume and peak expiratory flow rate (PEFR) in patients with tracheostomy. Methodology All adult patients with cuffed tracheostomy tubes with a Medical Research Council (MRC) score of more than 48 were studied. Volume-oriented incentive spirometry was performed and the PEFR was measured before and after the spirometry session. All patients underwent 28 sessions in seven days with initial few training sessions. Patient demographic information, such as age, gender, reasons for tracheostomy, MRC at the beginning of the session, volume (volume per breath, mL), and PEFR, was documented. Results Thirty patients were studied, consisting of 18 males and 12 females with initial MRC scores ranging from 48 to 60. The mean lung volume and mean PEFR at the end of seven days were 950 ± 330.9 and 134.7 ± 63.3, respectively, demonstrating safety with minimal complications, including four cases of pain at the tracheostomy site, three cases of hypotension, one case of abdominal pain, and 22 cases with no reported complications. Conclusion Volume-oriented incentive spirometry improves lung volume and PEFR in patients with a tracheostomy tube. Additionally, spirometry proved to be both feasible and effective in this patient population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Volume-Oriented Incentive Spirometry on Lung Volume and Peak Expiratory Flow Rate in Patients With Tracheostomy

Sankar Ganesh,

Abathsagayam,

Ravisankar

2024

Cureus

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“…Bloria et al proposed the use of a modified endotracheal tube as an adapter. 4 These modifications have been demonstrated to be safe in tracheostomized patients. 2 – 4 We propose another simple, inexpensive adaptation of the incentive spirometer for application in tracheostomized patients.…”

mentioning

confidence: 99%

“… 4 These modifications have been demonstrated to be safe in tracheostomized patients. 2 – 4 We propose another simple, inexpensive adaptation of the incentive spirometer for application in tracheostomized patients. It can be easily made using the catheter mount and elbow connectors, which are ubiquitous in an intensive care unit.…”

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confidence: 99%

A Simple Adaptation for the Convenient Application of Incentive Spirometry in Tracheostomized Critically Ill Patients

Arasu,

Singh,

LaguduvaH

2024

Indian Journal of Critical Care Medicine

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Lung Expansion Therapy for the Potential Populations: A Literature Review

Sankarganesh,

Abathsagayam,

Ravisankar

et al. 2023

Cureus

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Secretion retention, atelectasis, and reduced lung compliance occur when endotracheal or tracheostomised patients cough ineffectively. There is a possibility of infection if the collapsed regions of the lungs are not reinflated. Therefore, to improve clinical outcomes, such as diaphragm mobility and thickness, lung volume, and thickness of the abdominal muscles, and decrease the length of hospitalizations, mechanical and manual techniques, such as balloon blowing exercises and incentive spirometer, are required. PubMed, Google Scholar, Pedro, Clinical Keys, Helinet, ProQuest, and Science Direct databases were used for the literature search considering the inclusion and exclusion criteria. The several manual and mechanical methods that were employed for lung expansion treatment for the potential populations are highlighted in this overview of the literature. Ten studies were considered in this review: five on balloon-blowing exercises, four on tracheostomy with incentive spirometry exercises, and one on incentive spirometry with balloon-blowing exercises. The effects were examined on individual outcomes that included rate of perceived exertion (RPE), diaphragm mobility, pulmonary function, volume of breath, length of hospitalization, and postoperative day complications. The structured protocols proved to be effective in improving lung expansion and pulmonary function for the potential population that involved healthy adults, noncritical COVID-19 adults, smokers, thoracotomy patients, and tracheostomised patients. The road to recovery is yet unexplored and underachieved because of the lack of evidence.

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Using endotracheal tube as an adaptor to provide incentive spirometry to tracheostomised patients

Cited by 3 publications

References 1 publication

Impact of Volume-Oriented Incentive Spirometry on Lung Volume and Peak Expiratory Flow Rate in Patients With Tracheostomy

Impact of Volume-Oriented Incentive Spirometry on Lung Volume and Peak Expiratory Flow Rate in Patients With Tracheostomy

A Simple Adaptation for the Convenient Application of Incentive Spirometry in Tracheostomized Critically Ill Patients

Lung Expansion Therapy for the Potential Populations: A Literature Review

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