Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft

Area of Science:

• Pulmonary Medicine
• Cardiothoracic Surgery
• Evidence-Based Practice

Background:

• Incentive spirometry (IS) is a common postoperative respiratory therapy.
• Pulmonary complications are a significant concern following coronary artery bypass graft (CABG) surgery.
• This review updates previous evidence on IS for CABG patients.

Purpose of the Study:

• To systematically review and compare the effectiveness of IS versus other prophylactic physiotherapy methods.
• To assess the impact of IS on preventing postoperative pulmonary complications in adults undergoing CABG.
• To update a previous Cochrane review on this topic.

Main Methods:

• Systematic search of multiple databases including CENTRAL, MEDLINE, EMBASE, LILACS, PEDro, AMED, and CINAHL.
• Inclusion of randomized controlled trials comparing IS with other prophylactic physiotherapy interventions.
• Meta-analysis using generic inverse variance for continuous outcomes and Peto Odds Ratio for dichotomous data.

Main Results:

• Seven studies with 592 participants were included in this updated review.
• No significant difference was found in pulmonary complication rates or functional capacity between IS and other methods.
• IS was associated with worse pulmonary function and oxygenation compared to positive pressure breathing techniques.

Conclusions:

• Current evidence suggests IS offers no benefit in reducing pulmonary complications or improving pulmonary function post-CABG.
• The findings should be interpreted cautiously due to study limitations and small sample sizes.
• High-quality, adequately powered trials are necessary to definitively determine the role of IS in CABG patients.