From the Research
Using an incentive spirometer is generally not recommended for patients with pulmonary emboli. Patients with pulmonary emboli should avoid using incentive spirometers because the deep breathing exercises could potentially dislodge existing clots or create additional strain on the compromised pulmonary vasculature. Instead, these patients should follow their healthcare provider's specific breathing instructions, which typically involve gentle breathing exercises without the forced inspiration that incentive spirometers require. The primary treatment for pulmonary emboli focuses on anticoagulation therapy (such as heparin, low molecular weight heparins like enoxaparin, or direct oral anticoagulants), supplemental oxygen if needed, and careful monitoring 1. If breathing exercises are prescribed, they should be performed under direct medical supervision. Patients with pulmonary emboli should focus on maintaining normal breathing patterns, taking prescribed medications exactly as directed, staying adequately hydrated, and reporting any worsening symptoms such as increased shortness of breath, chest pain, or coughing up blood immediately to their healthcare provider.
Key Considerations
- The use of incentive spirometers in patients with pulmonary emboli is not supported by recent evidence 2, which focuses on the prevention of postoperative pulmonary complications after abdominal surgery, not the management of pulmonary emboli.
- The most recent and relevant study on the management of pulmonary embolism does not mention the use of incentive spirometers as a treatment option 1.
- The primary goal in managing pulmonary embolism is to prevent further clot formation and improve oxygenation, which can be achieved through anticoagulation therapy and supplemental oxygen, rather than deep breathing exercises 3, 4.
- Patients with pulmonary emboli should be closely monitored for signs of worsening symptoms, and any changes in their condition should be promptly reported to their healthcare provider 5.
Treatment Priorities
- Anticoagulation therapy to prevent further clot formation
- Supplemental oxygen to improve oxygenation
- Careful monitoring for signs of worsening symptoms
- Gentle breathing exercises, if prescribed, under direct medical supervision
- Avoidance of incentive spirometers due to the potential risk of dislodging existing clots or creating additional strain on the compromised pulmonary vasculature.