The Effect of Method of Administering Incentive Spirometry on Postoperative Pulmonary Complications in Coronary Artery Bypass Patients

Abstract

We studied whether the method of administering incentive spirometry to cardiac patients after the immediate postoperative recovery period would affect the rate of postoperative complications. METHODS: Sixty subjects undergoing elective coronary artery bypass surgery were supported in the cardiac surgical unit (CSU) approximately 48 hours and then transferred to a general care area, where each was randomly assigned to one of three groups. Group-1 subjects received incentive spirometry treatments via a Spirocare device four times daily under therapist supervision. Group-2 subjects received four supervised treatments daily via a disposable Voldyne device. Group-3 subjects used the disposable Voldyne device with no therapist supervision after initial instruction. No comparison control group without breathing exercises was used because the subjects were considered to be at risk for pulmonary complications. Complications were monitored by temperature, cough productivity, and degree of atelectasis seen on chest radiographs for 3 days after transfer from the CSU. Incentive volumes and length of hospital stay were recorded. RESULTS: No significant differences in complication rates were found among the three groups on any of the 3 days after transfer from the CSU. CONCLUSION: We conclude that in the patient population and circumstances we studied, the method of administering incentive spirometry after transfer from intensive care does not affect the rate of pulmonary complications as indicated by incentive spirometry volumes, temperature, cough productivity, degree of atelectasis on chest film, or length of hospital stay. However, these preliminary findings should not be extrapolated to other populations or clinical circumstances until further studies have been carried out. (Respir Care 1988:33:771-778.)