The effectiveness of incentive spirometry with physical therapy for high-risk patients after coronary artery bypass surgery

Background and Purpose. The purpose of this study was to determine whether the addition of incentive spirometry (IS) to postoperative pulmonary physical therapy is more effective than physical therapy alone in reducing postoperative pulmonary complications in high-risk patients after coronary artery bypass grafting (CABG). Patients were given the spirometer and instructed in its use, as often occurs in clinical settings. Subjects. Patients with chronic airflow limitation following CABG (N = 185) participated. Methods. Subjects were randomly assigned to receive either postoperative pulmonary physical therapy (breathing exercises, secretion removal, mobility) or physical therapy combined with IS. Results. No difference was found between the two groups in atelectasis, spirometry, oxygen saturation, pulmonary infection, or hospital stay. Conclusion and Discussion. Incentive spirometry combined with physical therapy is no more effective than postoperative physical therapy alone in reducing atelectasis for this population. Use of the spirometer, however, was not monitored, and although the study mimicked practice as it often occurs, the effectiveness of the spirometer cannot be fully evaluated.