The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery

School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. crowe@fhs.mcmaster.ca

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether the addition of incentive spirometry (IS) to postoperative pulmonary physical therapy is more effective than physical therapy alone in reducing postoperative pulmonary complications in high-risk patients after coronary artery bypass grafting (CABG). Patients were given the spirometer and instructed in its use, as often occurs in clinical settings. SUBJECTS: Patients with chronic airflow limitation following CABG (N = 185) participated. METHODS: Subjects were randomly assigned to receive either postoperative pulmonary physical therapy (breathing exercises, secretion removal, mobility) or physical therapy combined with IS. RESULTS: No difference was found between the two groups in atelectasis, spirometry, oxygen saturation, pulmonary infection, or hospital stay. CONCLUSION AND DISCUSSION: Incentive spirometry combined with physical therapy is no more effective than postoperative physical therapy alone in reducing atelectasis for this population. Use of the spirometer, however, was not monitored, and although the study mimicked practice as it often occurs, the effectiveness of the spirometer cannot be fully evaluated.

This article has been cited by other articles:

				E. H. J. Hulzebos, P. J. M. Helders, N. J. Favie, R. A. De Bie, A. Brutel de la Riviere, and N. L. U. Van Meeteren Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA, October 18, 2006; 296(15): 1851 - 1857. [Abstract] [Full Text] [PDF]

				E. Westerdahl, B. Lindmark, T. Eriksson, O. Friberg, G. Hedenstierna, and A. Tenling Deep-Breathing Exercises Reduce Atelectasis and Improve Pulmonary Function After Coronary Artery Bypass Surgery Chest, November 1, 2005; 128(5): 3482 - 3488. [Abstract] [Full Text] [PDF]

				A. H. O-Yurvati, M. S. Carnes, M. B. Clearfield, S. T. Stoll, and W. J. McConathy Hemodynamic Effects of Osteopathic Manipulative Treatment Immediately After Coronary Artery Bypass Graft Surgery J Am Osteopath Assoc, October 1, 2005; 105(10): 475 - 481. [Abstract] [Full Text] [PDF]

				R. Wynne and M. Botti Postoperative Pulmonary Dysfunction in Adults After Cardiac Surgery With Cardiopulmonary Bypass: Clinical Significance and Implications for Practice Am. J. Crit. Care., September 1, 2004; 13(5): 384 - 393. [Abstract] [Full Text] [PDF]

				P. Pasquina, M. R Tramer, and B. Walder Prophylactic respiratory physiotherapy after cardiac surgery: systematic review BMJ, December 13, 2003; 327(7428): 1379. [Abstract] [Full Text] [PDF]

				T. J. Overend, C. M. Anderson, S. D. Lucy, C. Bhatia, B. I. Jonsson, and C. Timmermans The Effect of Incentive Spirometry on Postoperative Pulmonary Complications : A Systematic Review Chest, September 1, 2001; 120(3): 971 - 978. [Abstract] [Full Text] [PDF]

				J. Weindler and R.-T. Kiefer The Efficacy of Postoperative Incentive Spirometry Is Influenced by the Device-Specific Imposed Work of Breathing Chest, June 1, 2001; 119(6): 1858 - 1864. [Abstract] [Full Text] [PDF]