Incentive Spirometry for Prevention of Postoperative Pulmonary Complications in Upper Abdominal Surgery

A Cochrane review [Abstract] 1 included 12 studies with a total of 1 834 subjects. Data from only 1 160 patients could be included in the meta-analysis. Incentive spirometry versus no respiratory treatment: There was no statistically significant difference in the incidence of clinical complications (RR 0.50, 95% CI 0.30 to 1.18, I² = 49%; 4 studies, n = 152). Incentive spirometry versus deep breathing exercises (DBE): There was no statistically significant difference in respiratory failure (RR 0.67, 95% CI 0.04 to 10.50, I² = 38%; 2 studies, n = 194). Incentive spirometry versus other chest physiotherapy: There was no statistically significant differences in the risk of developing a pulmonary condition (RR 0.83, 95% CI 0.51 to 1.34, statistical heterogeneity I² = 71%; 2 studies, n = 946) or type of complication.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), by inconsistency (unexplained variability in results), and by imprecise results (few patients and wide confidence intervals).

References

• do Nascimento Junior P, Módolo NS, Andrade S et al. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev 2014;(2):CD006058. [PubMed]