EFFECT OF PREOPERATIVE INCENTIVE SPIROMETRY IN PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS IN CARDIAC SURGICAL PATIENTS

Abstract

Objective: To evaluate the efficacy of pre-operative incentive spirometry versus no incentive spirometry before open heart surgery for the prevention of postoperative pulmonary complications (PPCs).

Study Design: Comparative analytical study.

Material and Methods: Consecutive adult patients who underwent elective open heart surgery during study time period were enrolled. The study participants were divided into two groups depending on their use of spirometry technique. Incentive Spirometer (IS) group consisted of patients who were educated about the Incentive Spirometry technique 3 days before surgery. While No IS group (NIS) consisted of participants who
were given IS after the open heart surgery.

Results: A total of 122 patients were enrolled in the study. IS group consisted of 61 patients while NIS group consisted of 60 patients. Mean age of the patients was 53 ± 11 years for IS and for NIS was 53 ± 13 years. IS group patients had better PaO2/FiO2 ratio of 395 ± 95, 359 ± 93 and 334 ± 59 at extubation, 6 hours after extubation and 24 hours after surgery respectively than that of 317± 73, 307 ± 89 and 301 ± 34 in the NIS group. IS group patients had better inspiratory effort of 250 ± 100 ml vs 150 ± 75 ml than NIS group patients 6 hours after extubation (p value 0.03). IS group had 600 ± 125 ml of inspiratory effort while NIS group patients had 350 ± 150 ml effort 24 hours after surgery (p value 0.04). There were less cases of pleural effusion, atelectasis and need of non-invasive ventilation in IS group as compared to NIS group but this difference was not statistically significant.

Conclusion: IS group patients had better post-operative recovery in immediate post-operative period. Therefore, we recommend pre-operative use of IS at least three days before surgery.