The Efficacy of Incentive Spirometers in Post-operative Protocols for Low-risk Patients

Abstract

Respiratory complications, including fever, atelectasis, pneumonia and respiratory failure, are the most frequent cause (20-40%) of postoperative morbidity and mortality (Bartlett, Gazzaniga & Geraghty, 1973). These complications are attributed to postoperative alveolar collapse with decreased vital capacity, functional residual capacity, absence of spontaneous sighs and retained secretions (Jackson, 1988; Peters & Turnier, 1980; Van De Water, 1980). Incentive spirometry (IS) is the most widely used technique to minimize these postoperative complications (O'Donohue, 1985). In a 1985 random survey of hospitals of varying size and geographic location in the United States, incentive spirometry was used in more than 95% of the hospitals and was used more widely than chest physiotherapy, intermittent positive pressure breathing (IPPB), blow bottles and continuous positive airway pressure (CPAP) (O'Donohue, 1985). In Canadian hospitals the frequency of usage of incentive spirometry had markedly increased. Not only was it being used for postoperative patients at high risk for pulmonary complications, but incentive spirometry was also being used by lower-risk patients on medical, obstetrical, gynecological and orthopedic wards. The increasing annual costs for equipment, distribution and respiratory personnel were of concern to administration.