Does an incentive spirometer help prevent blood clots?
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In recent years the focus in medicine has shifted towards efficient utilization of resources and improving patient outcomes. Incentive spirometry (IS) is a tool that mimics the natural process of yawning or sighing by allowing the user to take deep breaths in a controlled setting. This is a lung inflating maneuver that has been suggested to decrease the rate of pulmonary complications. The focus of utilization of IS and current studies has been predominantly on the post-operative surgical patient population. The mechanism of pulmonary complications in surgical patients is mixed in etiology possibly related to anesthesia, analgesics, pain and immobility leading to shallow breathing and subsequent atelectasis with concurrent hypoxia and risk of infection. The use of lung expanding maneuvers such as that provided by IS are thought to counteract shallow breathing thereby improving pulmonary outcomes. However, contrary to physiological theory, multiple studies and meta-analysis have failed to demonstrate its efficacy. The results of these studies are in direct conflict with what is expected scientifically. Show The authors of this paper set out to find the reason for discordant data in existing literature, and found that there have been multiple methodological limitations associated with existing studies; hence, interpretation and recommendations based on current data should be done with caution. The common denominator in repeated criticisms of existing studies is lack of reporting on patient compliance with IS after it is prescribed. This is a major confounder, in clinical experience IS is often observed sitting dormant at patients' bedside. These observations are in synchrony with criticisms reported in literature and raise serious questions about validity of existing data that should be acknowledged. Despite lack of convincing evidence, IS is routinely prescribed by physicians in hospital medicine. IS is a low cost tool, nevertheless, the increasing frequency of its use is accumulating to a larger proportion of health care costs. This calls for further evaluation with a study of higher methodological quality to address the limitations of prior studies. The scope of this study is different than that of existing studies in that it will evaluate the utility of IS in general medical patients. The sub-set of patients that are the focus of this study are those admitted with the chief complaint of "shortness of breath." The disease process in the former group leading to shortness of breath includes fluid over-load such as that in congestive heart failure, or an underlying lung process such as pneumonia, COPD, and/or pulmonary embolism. There is a parallel between mechanism of hypoxia in these patients and surgical patients in that these patients too often have pain and take high doses of analgesics, have shallow monotonous breathing and are immobile for long periods of time. From a physiological standpoint sustained maximal inhalation maneuvers may reverse and prevent progression of atelectasis by maintaining airway patency in all patients with shallow breathing of varying etiology not just the surgical sub-set. In a tertiary center community teaching hospital the effectiveness of IS in general medical wards will be evaluated using a single center randomized clinical trial. The goal is to offer a study that overcomes the limitations of prior studies. Lack of strong evidence based data has led to inconsistencies in practice of physicians leading to higher health care costs. The authors hope to design a study of high methodological quality to assess the effectiveness of IS in medical patients; thereby closing the knowledge gap in evidence based practices that may aid physicians in their decision to utilize IS. The name sounds complicated. But this is a simple handheld gadget that helps keep your lungs clear when you’re off your feet for a while. Maybe you’ve had surgery on your chest or belly, or you've fractured your ribs and find it painful to take deep breaths. Or you have
pneumonia or a lung condition like chronic obstructive pulmonary disease (COPD) or
cystic fibrosis. The breaths you take may not be as deep as usual. That means the air in your lungs may not move much and may not clear out any infections. You inhale through an incentive spirometer to exercise your lungs and to get air into every nook and cranny. Your doctor may also call it a manual incentive spirometer. It’s made of plastic and is about the size of a small notebook. It has a mouthpiece that looks like a vacuum tube. When you inhale with it, the suction will move a disc or a piston up inside a clear cylinder. The deeper you breathe, the higher the piston rises. Most spirometers have numbers on the cylinder to show how much air you take in. They also may have a gauge to tell
if you’re inhaling at the right pace. You may need a couple of tries to get the hang of it. After that, a spirometer is easy to use. Sit straight on a chair or the edge of your bed. If you’ve had surgery on your chest or belly, you may be sore there. Hold a pillow there to support it and help keep it from hurting. Breathe out completely to clear all the air from your lungs. Close your lips firmly around the mouthpiece. You’ll have to breathe in only through your mouth. Plug your nose if you need to. Breathe in slowly, and make the piston rise as high as you can while you keep the indicator between two arrows to know you are inhaling at the right pace. Then hold your breath up to 10 seconds. Note where the piston stopped. While you’re holding your breath, it will gradually sink. Loosen your lips from the mouthpiece when the piston hits the bottom of the cylinder. Breathe out slowly and rest for a bit. Do this 10 times, or as many as your doctor recommends. Aim to get the piston higher each time. When you finish,
cough to clear any mucus from your lungs. If you’re sore from surgery, hold the pillow against you while you cough. Repeat the
exercise every hour you’re awake, or as often as your doctor says. You can use a special spirometer if you have an opening in your windpipe because of a tracheotomy. It has a valve instead of a mouthpiece. You hook it up to the tracheostomy tube connected to your throat. BenefitsWhen you empty out and refill the air in your lungs, you get rid of fluid and germs that can lead to an infection. You also exercise your lungs, so that they’re able to put more oxygen into your body. That helps you to heal and avoid lung infections. If you’re having surgery, your doctor may want you to start using your spirometer at home before you head to the hospital. If you strengthen your lungs, you’re less likely to pick up an infection there. Experts debate the advantages of incentive spirometry. Studies show that deep breathing exercises appear to work just as well. Your doctor will suggest what may work best for you. What does an incentive spirometer prevent?An incentive spirometer helps prevent lung infections by expanding your lungs, strengthening your lungs, keeping your lungs inflated and clearing mucus and other secretions from your chest and lungs.
What are the benefits of incentive spirometer?Benefits of using an incentive spirometer
Using an incentive spirometer can improve overall lung function, which in turn increases the amount of oxygen that is breathed into the lungs, ultimately increasing the oxygen that ends up in the body. This device is also able to help patients clear mucus from their lungs.
When should a patient avoid using incentive spirometry?If you have an active respiratory infection, do not use your incentive spirometer around other people. A respiratory infection is an infection in your nose, throat, or lungs, such as pneumonia or COVID-19. This kind of infection can spread from person to person through the air.
What is the main goal for incentive spirometer?Introduction. The purpose of incentive spirometry is to facilitate a sustained slow deep breath. Incentive spirometry is designed to mimic natural sighing by encouraging patients to take slow, deep breaths.
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