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Evidence summaries

Incentive Spirometry for Preventing Pulmonary Complications after Coronary Artery Bypass Graft

Incentive spirometry may not be effective in reducing pulmonary complications and in decreasing the negative effects on pulmonary function in patients undergoing coronary artery bypass graft (CABG). Level of evidence: "C"

A Cochrane review [Abstract] 1 included 7 studies with a total of 592 subjects. In a population of low surgical risk, there was no significant difference in pulmonary complications (atelectasis and pneumonia) between treatment with incentive spirometry and physical therapy, treatment with positive pressure breathing techniques (including continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP) and intermittent positive pressure breathing (IPPB)), active cycle of breathing techniques (ACBT), or preoperative patient education. Patients treated with incentive spirometry had worse pulmonary function and arterial oxygenation compared with positive pressure breathing (CPAP, BiPAP, IPPB). There was no improvement in the muscle strength between groups who received IS demonstrated by maximal inspiratory pressure and maximal expiratory pressure.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment), and by inconsistency (heterogeneity in interventions and outcomes).

References

  • Freitas ER, Soares BG, Cardoso JR et al. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev 2012;(9):CD004466. [PubMed].

Primary/Secondary Keywords