Incentive spirometer

Abstract: An incentive spirometer (IS) is a mechanical device that promotes lung expansion. It is commonly used to prevent postoperative lung atelectasis and decrease pulmonary complications after cardiac, lung, or abdominal surgery. This study explored its effect on lung function and pulmonary complication rates in patients with rib fractures. Between June 2014 and May 2017, 50 adult patients with traumatic rib fractures were prospectively investigated. Patients who were unconscious, had a history of chronic obstructive pulmonary disease or asthma, or an Injury Severity Score (ISS) ≥ 16 were excluded. Patients were randomly divided into a study group (n = 24), who underwent IS therapy, and a control group (n = 26). All patients received the same analgesic protocol. Chest X-rays and pulmonary function tests (PFTs) were performed on the 5th and 7th days after trauma. The groups were considered demographically homogeneous. The mean age was 55.2 years and 68% were male. Mean pretreatment ISSs and mean number of ribs fractured were not significantly different (8.23 vs. 8.08 and 4 vs. 4, respectively). Of 50 patients, 28 (56%) developed pulmonary complications, which were more prevalent in the control group (80.7% vs. 29.2%; p = 0.001). Altogether, 25 patients had delayed hemothorax, which was more prevalent in the control group (69.2% vs. 29.2%; p = 0.005). Two patients in the control group developed atelectasis, one patient developed pneumothorax, and five patients required thoracostomy. PFT results showed decreased forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) in the control group. Comparing pre- and posttreatment FVC and FEV1, the study group had significantly greater improvements (p < 0.001). In conclusion, the use of an IS reduced pulmonary complications and improved PFT results in patients with rib fractures. The IS is a cost-effective device for patients with rib fractures and its use has clinical benefits without harmful effects. ClinicalTrials.gov, NCT04006587. Registered on 3 July 2019.

Abstract: A unique adaptor and improved incentive spirometer for delivering medication to patients from metered dose inhaler canisters. The improved apparatus is comprised of a unique universal adaptor has an inlet configured to receive a variety of incentive devices, an outlet to connect a mouthpiece and a socket for receiving a metered dose medication canister. The socket is constructed to accept a wide variety of metered dose inhaler spray tips and includes a nozzle spray tip constructed to provide optimum misting. The inlet of the unique, universal adaptor is constructed to receive a variety of incentive devices to improve medication penetration. An improved incentive spirometer for connection to the inlet of the unique universal adaptor is also disclosed. The improved incentive spirometer may also be used for efficient inspiratory and expiratory volume exercising.

Abstract: This study evaluated the relative effects of three experimental videotapes that involved different approaches for preparing coronary artery bypass graft (CABG) patients for surgery and the inhospital recovery period. One of the tapes conveyed information via a health care expert only. The other two featured the same health care expert and also included clips of interviews with patient models. These latter two tapes differed in the extent to which they portrayed the recovery period as a steady, forward progression or as consisting of “ups and downs.” Two hundred fifty-eight male CABG patients were randomly assigned to view one of the three videotapes on the evening prior to surgery or to a control condition. Overall, patients who viewed any of the videotapes felt significantly better prepared for the recovery period, reported higher self-efficacy for using the incentive spirometer and for speeding their recovery, performed more repetitions with their incentive spirometer each time they used it postoperatively, had shorter intensive care unit stays, and were released from the hospital more quickly than patients in the control condition. There was also evidence that patients’ self-efficacy beliefs for speeding recovery directly mediated the effects of the videotapes on length of stay both in the intensive care unit and in the hospital.

Abstract: Introduction: Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim: To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods: A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results: Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups.The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Conclusion: Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.