What is an incentive spirometer?

From the Guidelines

Incentive spirometry should not be used as a standalone technique for postoperative pulmonary rehabilitation after lobectomy, but rather considered on a case-by-case basis as part of a multimodal management plan. The use of incentive spirometry has been studied in various contexts, including postoperative pulmonary rehabilitation after lobectomy. According to a study published in Anaesthesia in 2021 1, the addition of incentive spirometry to a set of physiotherapy techniques failed to improve the patient's prognosis. In fact, studies have shown that physiotherapist-supervised postoperative chest physiotherapy, including incentive spirometry, had no impact on the pulmonary complication rate compared to early mobilization and walking, intensive pain management, and preoperative education concerning postoperative respiratory physiotherapy 1.

Some key points to consider when using an incentive spirometer include:

• Holding the device upright and placing the mouthpiece in your mouth, sealing your lips tightly around it
• Inhaling slowly and deeply to raise the indicator ball or piston to the target level
• Holding your breath for 3-5 seconds, then exhaling normally
• Repeating this exercise 10 times every hour while awake
• Combining with coughing exercises to clear secretions
• Using the spirometer as prescribed and sitting upright when possible

It is essential to note that the most effective approach to postoperative pulmonary rehabilitation after lobectomy is a multimodal management plan that combines early mobilization and walking, breathing exercises, and bronchial drainage and coughing techniques, with pain management education as part of this management 1. The addition of other techniques, such as incentive spirometry, should be considered on a case-by-case basis, but not applied alone.

From the Research

Incentive Spirometer Overview

• An incentive spirometer is a medical device used to help patients improve their lung function, particularly after surgery or in cases of respiratory disease 2.
• The device provides a visual incentive for patients to take deep breaths, helping to increase lung volume and reduce the risk of pneumonia.

Efficacy of Incentive Spirometer

• A study published in 2021 found that the use of an incentive spirometer in an outpatient setting resulted in a significant increase in maximal inspiratory volume, with an average increase of 16% over a 30-day period 2.
• The study included 48 patients who used the incentive spirometer three times a day, in addition to performing light exercises and postural drainage.
• The results showed a significant difference between baseline and maximum volumes, with no significant difference among week 1-4 averages.

Other Studies

• A study published in 1993 investigated the effects of halothane on cytosolic calcium transient in tracheal smooth muscle, but did not provide direct evidence on the efficacy of incentive spirometers 3.
• This study focused on the effects of halothane on smooth muscle cells and did not involve the use of incentive spirometers.

Key Findings

• The use of an incentive spirometer can lead to significant improvements in lung function, particularly in maximal inspiratory volume 2.
• Patients who used the incentive spirometer in the study did not report any symptoms or COVID-19 infection during the 30-day period, and did not need to contact their primary care physician.