HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Weindler, J. Articles by Kiefer, R.-T. Search for Related Content PubMed PubMed Citation Articles by Weindler, J. Articles by Kiefer, R.-T.

The Efficacy of Postoperative Incentive Spirometry Is Influenced by the Device-Specific Imposed Work of Breathing^*

^* From the Department of Ophthalmology (Dr. Weindler),University of the Saarland, Germany; and Department of Anesthesiology and Intensive Care Medicine (Dr. Kiefer), Eberhard-Karls University, Tuebingen, Germany.

Correspondence to: Ralph-Thomas Kiefer, MD, IASP, ESA, DGSS, Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls University, Hoppe-Seyler-Strasse 3, 72 076 Tuebingen, Germany; e-mail: Thomas.Kiefer{at}uni-tuebingen.de

Study objectives: The study evaluated the impact of the additional imposed work of breathing (WBimp) generated by two different spirometers on postoperative incentive spirometry performance in patients at high risk and moderate risk for postoperative pulmonary complications (PPCs). Additionally, we investigated whether maximal inspiratory pressure (PImax) is an easy estimate of the WBimp imposed by incentive spirometers.

Design: Prospective, randomized, single-blind clinical trial.

Setting: ICU of a university hospital.

Interventions and measurements: Thirty male patients were assigned to a group at high risk for PPCs (group A; inspiratory capacity [IC], < 1.6 L) or to a group at moderate risk for PPCs (group B; IC, 1.6 to 2.5 L) after upper-abdominal, thoracic, or two-cavity surgery. On the first or second postoperative day WBimp, IC, and PImax were recorded without spirometers (baseline) and during incentive spirometry with the Mediflo spirometer (Medimex; Hamburg, Germany) (high WBimp) and the Coach spirometer (Kendall; Neustadt, Germany) (low WBimp) using a pneumotachograph. In group A, the baseline and the ICs for both spirometers only differed slightly. In group B, the IC was significantly reduced for the Mediflo (p < 0.05), which imposed a WBimp twice as high as the Coach (p < 0.01). PImax was significantly increased for both the Mediflo and the Coach (p < 0.01). PImax was positively correlated with WBimp (r = 0.8).

Conclusions: Incentive spirometers differ considerably in their additional Wbimp with a potential impact on the efficacy of postoperative incentive spirometry performance. PImax might be an easy clinical estimate for the WBimp during incentive spirometry. Incentive spirometers with low WBimp permit increased maximal sustained inspiration and, thus, enhanced incentive spirometry performance, and, therefore, it might be more suitable for use in postoperative respiratory care.

Key Words: incentive spirometry • inspiratory capacity • maximal sustained inspiration • respiratory care • work of breathing

This article has been cited by other articles:

				G. Varela, E. Ballesteros, M. F. Jimenez, N. Novoa, and J. L. Aranda Cost-effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy Eur. J. Cardiothorac. Surg., February 1, 2006; 29(2): 216 - 220. [Abstract] [Full Text] [PDF]