3 : It is suggested that deep breathing exercises provide the same benefit as incentive spirometry in the preoperative and postoperative setting to prevent postoperative pulmonary complications .
Positive expiratory pressure device acceptance by hospitalized children with sickle cell disease is comparable to incentive spirometry.
BACKGROUND The pulmonary complication in sickle cell disease known as acute chest syndrome ( ACS ) has potential for high morbidity and mortality . A r and omized trial demonstrated that incentive spirometry ( IS ) reduces the rate of ACS , leading to a role for respiratory therapy in hospital management of sickle cell pain . However , use of IS can be limited by chest wall pain , or by difficulty with the coordinated inspiration in a young child .  Intermittent positive expiratory pressure ( PEP ) therapy may be easier for a child 's coordination and more comfortable than IS for a child with chest wall pain . PURPOSE To compare PEP therapy with conventional IS for children hospitalized for sickle cell pain with respect to patient satisfaction , length of hospital stay , and progression to ACS . METHODS This pilot study enrolled 20 children upon hospitalization for sickle cell pain in the thorax , r and omly assigning them to either PEP ( n = 11 ) or IS ( n = 9 ) therapy , administered by a therapist hourly while awake . RESULTS The r and omization assigned an older distribution to PEP than IS ( 12.3 vs 8.8 y ) . Patient satisfaction was high for both respiratory care devices , and there was no difference between the PEP and IS groups ( 4.5 vs 4.4 , p = 0.81 ) . Length of hospital stay was similar ( 5 vs 4.3 d , p = 0.56 ) . No children in either group progressed to ACS . CONCLUSION These preliminary results show no difference in the primary outcomes in the 2 groups . Intermittent PEP therapy warrants further study as an alternative to IS for sickle cell patients at high risk for ACS , as effective preventive respiratory therapy
3 : It is suggested that deep breathing exercises provide the same benefit as incentive spirometry in the preoperative and postoperative setting to prevent postoperative pulmonary complications .