From the Guidelines
Incentive spirometry is contraindicated in patients with severe respiratory conditions, such as life-threatening hypoxaemia, haemodynamic instability, and severe co-morbidity, as well as those with impaired consciousness, confusion, or agitation, as evidenced by a study on non-invasive ventilation in acute respiratory failure 1. When considering the use of incentive spirometry, it is essential to assess the patient's ability to participate and their respiratory status. Contraindications to incentive spirometry include:
- Recent facial, upper airway, or upper gastrointestinal tract surgery
- Fixed obstruction of the upper airway
- Inability to protect airway
- Life-threatening hypoxaemia
- Haemodynamic instability
- Severe co-morbidity
- Impaired consciousness
- Confusion or agitation
- Vomiting
- Bowel obstruction
- Copious respiratory secretions
- Focal consolidation on chest radiograph
- Undrained pneumothorax, as outlined in a study on non-invasive ventilation in acute respiratory failure 1. Incentive spirometry works by encouraging deep breathing to expand the lungs, prevent atelectasis, and improve oxygenation. However, in patients with contraindications, alternative lung expansion techniques such as deep breathing exercises, early mobilization, or positive airway pressure therapy may be more appropriate. It is crucial to prioritize the patient's safety and respiratory status when deciding whether to use incentive spirometry, and to consider alternative treatments when contraindications are present, as suggested by the study on non-invasive ventilation in acute respiratory failure 1.
From the Research
Incentive Spirometry Contraindications
- The use of incentive spirometry may be contraindicated in certain patients, such as those with bullous emphysema, as it may cause mechanical stress on the lung tissue and lead to pneumothorax 2.
- Patients with primary spontaneous pneumothorax may not be suitable for incentive spirometry, especially if they have significant symptoms or life-threatening respiratory distress 3.
- There is no clear contraindication for the use of incentive spirometry in patients with chronic obstructive pulmonary disease (COPD), and it may even be beneficial in improving respiratory muscle strength and reducing symptoms 4.
- Incentive spirometry may not be suitable for patients who are unable to perform the required maneuvers, such as those with severe respiratory muscle weakness or those who are unable to understand or follow instructions.
- The use of incentive spirometry in patients with certain lung conditions, such as pneumothorax or bullous emphysema, should be done with caution and under close medical supervision 2, 3.