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Incentive Spirometry After Lung Resection: A Randomized Controlled Trial.

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Adding incentive spirometry (IS) to physiotherapy after lung resection did not lower postoperative pulmonary complications (PPC). This study found no significant benefit of IS over standard physiotherapy for reducing PPC rates.

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Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery
  • Critical Care

Background:

  • Postoperative pulmonary complications (PPC) are a concern after lung resection.
  • Incentive spirometry (IS) is a common intervention to prevent PPC.

Purpose of the Study:

  • To evaluate if adding IS to routine physiotherapy reduces PPC after lung resection compared to physiotherapy alone.

Main Methods:

  • A single-blind prospective randomized controlled trial included 387 adults undergoing lung resection.
  • Participants received either routine physiotherapy (PHY) or physiotherapy plus IS (PHY/IS).
  • The primary outcome was the incidence of PPC at 30 days postoperatively.

Main Results:

  • No significant difference in PPC incidence was observed between the PHY/IS and PHY groups (12.3% vs. 13.0%, p=0.88).
  • Rates of pneumonia, mechanical ventilation, home oxygen use, hospital length of stay, and readmission were also similar between groups.
  • Baseline characteristics and surgical procedures (e.g., lobectomy, minimally invasive vs. open) were comparable.

Conclusions:

  • The addition of IS to routine physiotherapy does not decrease the incidence of PPC following lung resection.
  • Current evidence does not support the routine use of IS in this patient population beyond standard physiotherapy.