Nurse-guided incentive spirometry use and postoperative pulmonary complications among cardiac surgery patients: A randomized controlled trial

Aims: To assess the effect of nurse-guided use of incentive spirometer on postoperative oxygenation and pulmonary complications after coronary artery bypass graft surgery. Background: Deep breathing exercises have been shown to improve postoperative lung expansion and reduce pulmonary complications. An incentive spirometer is a deep breathing exercises device that imitates continuous sigh-like maximal inspiration. Design: Randomized control trial, two groups nonblinded parallel design. Methods: A total of n = 89 eligible patients were randomized to either control or intervention group. Patients in the intervention group received bihourly nurse-guided incentive spirometry for 48-h postextubation. The endpoints were: the number and duration of hypoxic events during the first 24-hr postsurgery, pneumonia and pulmonary function parameters. Data were collected May to September 2019. Results: Patients in the intervention group had a significantly lower mean number of hypoxic events with shorter duration and shorter length of stay in the hospital and the ICU. Patients in the intervention group also had greater postoperative forced expiratory volume in 1 second. Conclusion: Nurse-guided use of the incentive spirometer reduces the risk of pulmonary complications and hospital length of stay after cardiac surgery.