Why is incentive spirometer important after surgery?
Original Editor- Alex Palmer Show
Top Contributors - Kudzanayi Ronald Muzenda, Alex Palmer, Kim Jackson, Rucha Gadgil, Uchechukwu Chukwuemeka, Rachael Lowe, Joao Costa, Evan Thomas, WikiSysop, Adam Vallely Farrell, Karen Wilson and Candace Goh Introduction[edit | edit source]The purpose of incentive spirometry is to facilitate a sustained slow deep breath. Incentive spirometry is designed to mimic natural sighing by encouraging patients to take slow, deep breaths. Incentive spirometry is performed using devices which provide visual cues to the patients that the desired flow or volume has been achieved. The basis of incentive spirometry involves having the patient take a sustained, maximal inspiration (SMI). An SMI is a slow, deep inspiration from the Functional Residual Capacity up to the total lung capacity, followed by ≥5 seconds breath hold. An incentive spirometer is a medical device that facilitate SMI with incorporated visual indicators of performance (inspiratory effort) in order to aid the therapist in coaching the patient to optimal performance and likewise patients uses this visual feedback to monitor their own efforts. The device gives the individual visual feedback regarding flow and volume and also prevent and reverse atelectasis when used appropriately and regularly.[1] The visual dimension of the therapy serves as a motivation or goal for the patient to try to meet by repeating the maximal effort frequently. There are typically two types of incentive spirometer, namely:
Image: Overview of the respiratory system[4] Guidelines on appropriate use[edit | edit source]
Further pointers:
The video below explains more on the use of the incentive spirometer [5] Indications[edit | edit source]The indications are:[6]
Contraindications[edit | edit source]The Contra-indications are[9][10]:
Precautions[edit | edit source]Certain Precautions need to be taken when using the spirometer[8][11]:
Evidence[edit | edit source]A moderate body of evidence has examined the use of incentive spirometry and it's effectiveness following a variety of surgeries and reducing the risk of post-operative complications. It's effectiveness has been varied but all systematic reviews highlight flaws in methodology of studies carried out. A systematic review carried out by Overend et al., 2001 reviewed the evidence examining the use of incentive spirometry for the prevention of postoperative pulmonary complications.[12] Due to flaws in study methodology they concluded that at present, the evidence does not support the use of incentive spirometry for decreasing the incidence of post operative pulmonary complications following cardiac or upper abdominal surgery. A recent systematic review completed in 2016 examined the evidence regarding patient compliance with incentive spirometry after cardiac, thoracic and abdominal surgery.[13] They concluded that there is a scarcity and inconsistency of evidence regarding incentive spirometry compliance. They identified the importance of reporting this outcome measure to examine the effectiveness of this treatment adjunct. A randomised controlled trial was conducted to compare pre-operative and post-operative effects of Diaphragmatic Breathing Exercise (DBE), Flow-incentive Spirometer and Volume-incentive spirometer on pulmonary function in CAGB patients.[3] The study concluded that Volume-incentive spirometer has the greater effect among the other two. References[edit | edit source]
What is the benefit of incentive spirometry?Benefits of using an incentive spirometer
Using an incentive spirometer can improve overall lung function, which in turn increases the amount of oxygen that is breathed into the lungs, ultimately increasing the oxygen that ends up in the body. This device is also able to help patients clear mucus from their lungs.
What are the nurses role with an incentive spirometer?Nurse's role with an Incentive Spirometer:
Observing and encouraging patient to use it often. Monitoring lung sounds for improvement: For example, if the patient has atelectasis the lungs will sound diminished or bronchial breath sounds may be heard in the peripheral lung fields, or crackles.
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