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Incentive spirometry: its value after cardiac surgery

G D Gale, D E Sanders

    Canadian Anaesthetists' Society Journal
    |September 1, 1980
    PubMed
    Summary
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    Intermittent positive pressure breathing (IPPB) and incentive spirometry (I.S.) showed no significant difference in preventing atelectasis after heart surgery. More frequent incentive spirometer use may be more effective.

    Area of Science:

    • Cardiology
    • Pulmonary Medicine
    • Postoperative Care

    Background:

    • Post-heart surgery patients are at risk for atelectasis.
    • Respiratory interventions like IPPB and I.S. are commonly used.
    • Preoperative patient instruction is standard practice.

    Purpose of the Study:

    • To compare the efficacy of IPPB and I.S. in preventing postoperative atelectasis.
    • To assess the impact of these treatments on vital capacity and arterial oxygen tension.
    • To evaluate radiological signs of atelectasis.

    Main Methods:

    • A randomized comparison of IPPB and I.S. in 109 post-cardiac surgery patients.
    • Preoperative patient education on both treatment modalities.
    • Postoperative assessment of vital capacity, arterial oxygen tension, and atelectasis incidence.

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    Main Results:

    • No significant differences in vital capacity, arterial oxygen tension, or atelectasis between IPPB and I.S. groups over three days.
    • A transient, statistically significant drop in arterial oxygen tension occurred post-IPPB.
    • Arterial oxygen tension normalized within 60 minutes for both groups.

    Conclusions:

    • Standard use of incentive spirometry (four times daily) is not superior to IPPB for preventing atelectasis after open-heart surgery.
    • More frequent incentive spirometer application might offer improved outcomes.
    • Both interventions appear safe regarding short-term oxygenation changes.