Abstract
BackgroundPostoperative pulmonary complications (PPCs) often occur after cardiac operations and are a leading cause of morbidity, inhibit oxygenation, and increase hospital length of stay and mortality. Although clinical evidence for PPCs prevention is often unclear and crucial, measures occur to reduce PPCs. One device usually used for this reason is incentive spirometry (IS). The aim of the study is to evaluate the effect of preoperative incentive spirometry to prevent postoperative pulmonary complications, improve postoperative oxygenation, and decrease hospital stay following coronary artery bypass graft (CABG) surgery patients.MethodsThis was a clinical randomized prospective study. A total of 80 patients were selected as candidates for CABG at An-Najah National University Hospital, Nablus-Palestine. Patients had been randomly assigned into two groups: incentive spirometry group (IS), SI performed before surgery (study group) and control group, preoperative spirometry was not performed. The 40 patients in each group received the same protocol of anesthesia and ventilation in the operating room.ResultThe study findings showed a significant difference between the IS and control groups in the incidence of postoperative atelectasis. There were 8 patients (20.0%) in IS group and 17 patients (42.5%) in the control group (p = 0.03). Mechanical ventilation duration was significantly less in IS group. The median was four hours versus six hours in the control group (p < 0.001). Hospital length of stay was significantly less in IS group, and the median was six days versus seven days in the control group (p < 0.001). The median of the amount of arterial blood oxygen and oxygen saturation was significantly improved in the IS group (p < 0.005).ConclusionPreoperative incentive spirometry for two days along with the exercise of deep breathing, encouraged coughing, and early ambulation following CABG are in connection with prevention and decreased incidence of atelectasis, hospital stay, mechanical ventilation duration and improved postoperative oxygenation with better pain control. A difference that can be considered both significant and clinically relevant.Trial registration Thai Clinical Trials Registry: TCTR20201020005. Registered 17 October 2020—retrospectively registered.
Highlights
Coronary artery disease (CAD) is the leading cause of death and disability worldwide [1]
There are no significant differences between the incentive spirometry (IS) Group and the Control Group in all general characteristics of patients exhibited at the table 0.05 level (p value > 0.05)
The current study results are consistent with Oshvandi et al [11], who was showed that the occurrence of atelectasis, respiratory status, dyspnea, and sweating showed a significant difference between the IS and control groups at all hours after surgery (p < 0.001)
Summary
Coronary artery disease (CAD) is the leading cause of death and disability worldwide [1]. Postoperative pulmonary complications (PPCs) are a frequent incident following cardiac, thoracic, and abdominal surgeries [3]. PPC complications contribute significantly to morbidity, mortality, and hospitalization costs [5]. These complications include atelectasis, pulmonary infections such as pneumonia and bronchitis, pleural effusion, pulmonary edema, and respiratory insufficiency [6]. Postoperative pulmonary complications (PPCs) often occur after cardiac operations and are a leading cause of morbidity, inhibit oxygenation, and increase hospital length of stay and mortality. The aim of the study is to evaluate the effect of preoperative incentive spirometry to prevent postoperative pulmonary complications, improve postoperative oxygenation, and decrease hospital stay following coronary artery bypass graft (CABG) surgery patients
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