Comparing the efficacy of incentive spirometry and PEP in reducing post operative pulmonary complications after thoracotomy and upper abdominal surgery

Abstract

Due to the lack of incentive spirometry studies in developing countries and the unavailability of this device in all centers and on the other hand due to the ease of deep exhalation against positive pressure, in this study the effect of incentive spirometry compared to Deep exhaustion versus positive pressure in reducing pulmonary complications after thoracotomy and upper abdomen. Materials and Methods: This study was a cross-sectional study that was performed during 2019-2020 with the participation of 90 patients candidates for thoracotomy and upper abdomen surgery and hospitalized in the intensive care unit of Imam Reza Hospital (Tabriz University of Medical Sciences). They underwent general anesthesia and all were extubated after surgery. Two types of treatment were performed for patients admitted to the intensive care unit. For one group, spirometry encouragement (every three hours for ten minutes) and for the other group, deep exhalation against positive pressure (inflating a balloon - every three hours for ten minutes) for three days for both. The group was done. Data from pulmonary volumes and arterial blood gases, the need for mechanical ventilation in the intensive care unit and complications and mortality were recorded in both groups. Data were collected in SPSS Ver21 software and compared with T test and chi square statistical tests with alpha significance level less than 0.05. Results: At the end of the first day, it was seen that there was no statistically significant difference between the variables Pao2 and Paco2 (P <0.05); However, the comparison of these variables on the second and third day showed a statistically significant relationship between the two groups, so that a good improvement in the incentive spirometry method was observed in patients (P <0.05); Also, the rate of atelectasis, duration of hospitalization, need for adjuvant oxygen in the stimulus spirometry group is significantly lower than the deep exhalation group against positive pressure (P <0.05) while in the need for mechanical ventilation, the duration of hospitalization There is no statistically significant difference between the two groups in the intensive care unit, pneumonia and mortality (P <0.05).