CONCLUSION There was no evidence to support the use of incentive spirometry in the management of surgical patients .
OBJECTIVE To conduct a systematic review to evaluate the evidence of the use of incentive spirometry ( IS ) for the prevention of postoperative pulmonary complications and for the recovery of pulmonary function in patients undergoing abdominal , cardiac and thoracic surgeries .
Prevention of respiratory complications after abdominal surgery: a randomised clinical trial
Abstract Objective : To evaluate the prevention of respiratory complications after abdominal surgery by a comparison of a global policy of incentive spirometry with a regimen consisting of deep breathing exercises for low risk patients and incentive spirometry plus physiotherapy  for high risk patients . Design : Stratified r and omised trial . Setting : General surgical service of an urban teaching hospital . Patients : 456 patients undergoing abdominal surgery . Patients less than 60 years of age with an American Society of Anesthesia classification of 1 were considered to be at low risk . Outcome measures : Respiratory complications were defined as clinical features consistent with collapse or consolidation , a temperature above 38 ° C , plus either confirmatory chest radiology or positive results on sputum microbiology . We also recorded the time that staff devoted to prophylactic respiratory therapy . Results : There was good baseline equivalence between the groups . The incidence of respiratory complications was 15 % ( 35/231 ) for patients in the incentive spirometry group and 12 % ( 28/225 ) for patients in the mixed therapy group ( P=0.40 ; 95 % confidence interval -3.6 % to 9.0 % ) . It required similar amounts of staff time to provide incentive spirometry and deep breathing exercises for low risk patients . The inclusion of physiotherapy for high risk patients , however , result ed in the utilisation of an extra 30 minutes of staff time per patient . Conclusions : When the use of re sources is taken into account , the most efficient regimen of prophylaxis against respiratory complications after abdominal surgery is deep breathing exercises for low risk patients and incentive spirometry for high risk patients . Key messages Key messages Most postoperative respiratory complications were due to atelectasis : less than 1 % of the patients developed pneumonia An American Society of Anesthesia classification > 1 and an age > /=60 years is a simple way of defining patients at high risk of respiratory complications and other adverse events after abdominal surgery A regimen consisting of deep breathing exercises ( low risk patients ) and incentive spirometry ( high risk patients ) is an efficient way of providing prophylaxis against respiratory complications after abdominal
CONCLUSION There was no evidence to support the use of incentive spirometry in the management of surgical patients .
OBJECTIVE To conduct a systematic review to evaluate the evidence of the use of incentive spirometry ( IS ) for the prevention of postoperative pulmonary complications and for the recovery of pulmonary function in patients undergoing abdominal , cardiac and thoracic surgeries .