Chest
Volume 78, Issue 1, July 1980, Pages 31-35
Journal home page for Chest

Comparison of Three Methods of Respiratory Care following Upper Abdominal Surgery

https://doi.org/10.1378/chest.78.1.31Get rights and content

Incentive spirometry, as a method for preventing postoperative atelectasis, was compared with intermittent positive-pressure breathing (IPPB) and resistance breathing in 126 patients undergoing upper-abdominal surgery, most of whom had cholecystectomy. There was no statistically significant difference in the incidence of atelectasis among the three groups, who were matched for age, sex, smoking history, previous respiratory disease, and duration of surgery. There was a significantly higher incidence of atelectasis in patients over the age of 50 yean (P = 0.004) than in younger subjects, where the incidence was not different among the three groups. Incentive spirometric therapy, as used in this study, offered no advantage over the other methods of treatment.

Section snippets

MATERIALS AND METHODS

One hundred fifty patients on the general surgical service of the Los Angeles County/University of Southern California Medical Center who were undergoing elective upper-abdominal surgery were the subjects of this study. Because of incomplete data, 24 patients were excluded, so that 126 individuals comprised the substance of this study. After obtaining an informed consent, each patient was randomly assigned to one of the following groups for treatment, using a system of computer-generated random

RESULTS

The characteristics of the three groups are shown in Table 1. The majority of the patients in all three groups were middle-aged women who underwent gall bladder resection. The surgical procedure usually lasted no more than three hours. All patients had general anesthesia, with cyclopropane or nitrous oxide as the anesthetic agent. They had been smoking less than one pack of cigarettes per day and had no past history of pulmonary disease. There were no statistically significant differences in

DISCUSSION

Based upon the results of this study, it would appear that when used in the manner described herein, incentive spirometric therapy is not superior to resistance breathing in the prevention of postoperative pulmonary complications. Both are only slightly better than IPPB. Whether or not any one of the methods of treatment significantly reduced the incidence of atelectasis in contrast to no therapy cannot be answered, due to the absence of a control group; however, the purpose of our study was to

ACKNOWLEDGMENT

We thank Ms. Rachel Knox and Mr. James Stuart for technical assistance.

REFERENCES (21)

There are more references available in the full text version of this article.

Cited by (42)

  • Postoperative respiratory management of morbidly obese patient

    2013, Trends in Anaesthesia and Critical Care
    Citation Excerpt :

    The early mobilization, postural changes, assisted cough, and other methods have proven efficacy in bronchial toilet and reducing respiratory complications in these patients.58,59 Increasing lung volume is a way to reduce postoperative complications, and one of the most used methods is the use of volumetric incentive because it encourages deep breathing, requires minimal supervision and fewer staff, and is a cheap technique for achieving the target lung volume.63,64 However, a recent review concluded that no evidence exists that the volumetric incentive spirometer is effective in preventing respiratory complications,65 but this is partly due to the lack of well-designed trials.

  • Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery: A systematic review

    2006, Chest
    Citation Excerpt :

    There was one redundancy unit15; we regarded the more detailed article as the original report16 and excluded the duplicate.17 We eventually analyzed data from 35 randomized trials with data on 4,145 adult patients (Table 1).16,1819,2021,2223,2425,2627,2829,3031,3233,3435,3637,3839,4041,4243,4445,4647,4849,50,51 Trials came from 12 countries and were published between 1952 and 2005.

View all citing articles on Scopus

Supported by Marion Laboratories.

Manuscript received June 11; revision accepted August 28.

View full text