Incentivert Spirometri
- Fysiobasen
- Oct 4
- 2 min read
Indications and Contraindications
Indications
Incentive spirometry is recommended for:
Preoperative screening: Identifying patients at risk for postoperative pulmonary complications.
Atelectasis: Treatment and prevention of lung collapse.
Surgery: Used after abdominal or thoracic surgery, especially in patients with COPD or reduced inspiratory capacity (<2.5 liters)⁵.
Contraindications
Use of incentive spirometry is contraindicated in the following cases⁶:
Inability to use the device without constant supervision.
Uncooperative patients or children with developmental delays.
Conditions such as hyperventilation, hypoxemia, or severe dyspnea.
Pain, sedation, or diaphragmatic dysfunction that prevents deep breathing.
Clinical Benefits and Evidence
Clinical Benefits
Incentive spirometry has been shown to:
Reduce the risk of atelectasis and improve diaphragmatic function.
Prevent postoperative pulmonary complications such as pneumonia and hypoxemia.
Provide visual feedback that motivates patients to actively engage in their own treatment.
Evidence and Critical Appraisal
A systematic review by Overend et al. (2001) concluded that incentive spirometry provides limited evidence for reducing postoperative complications following cardiac and abdominal surgery⁷.
A more recent study from 2016 highlighted the importance of patient compliance but also emphasized methodological weaknesses in existing research⁸.
Despite these limitations, some studies have shown that volume-oriented spirometers produce better outcomes compared to other methods³.
Sikkerhetsforanstaltninger og Praktiske Tips
Safety Precautions and Practical Tips
Precautions
Incentive spirometry should not be the sole treatment for major lung collapse or consolidation.
Monitor for hyperventilation or bronchospasm, particularly in patients with reactive airways.
Avoid excessive use in patients with emphysematous lungs to reduce the risk of barotrauma⁹.
Practical Tips
Integrate incentive spirometry with other physiotherapy techniques, such as coughing exercises and mobilization, to maximize results.
Ensure patients receive clear instructions and regular follow-up to guarantee correct use.
Conclusion
Incentive spirometry is a valuable tool in physiotherapy practice, particularly for preventing and treating postoperative pulmonary complications. While scientific evidence remains variable, clinical experience highlights its value as a complementary method alongside other treatments. For optimal benefit, usage should always be tailored to the patient’s individual needs and conditions.
References
Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive Spirometry: 2011, AARC Clinical Practice Guideline. Respiratory Care; 56:10, 2011.
Pryor JA, Webber BA. Physiotherapy for Respiratory and Cardiac Problems. 2nd Edition. London: Churchill Livingstone; 1998.
Alaparthi GK, Augustine AJ, Anand R, Mahale A. Comparison of diaphragmatic breathing exercise, volume and flow incentive spirometry on diaphragm excursion and pulmonary function in patients undergoing laparoscopic surgery: A randomized controlled trial. Minimally Invasive Surgery; 2016.
Westwood K, Griffin M, Roberts K, Williams M, Yoong K, Digger T. Incentive Spirometry Decreases Respiratory Complications Following Major Abdominal Surgery. Surgeon; 2007.
Renault JA, Costa-Val R, Rossetti MB. Respiratory Physiotherapy in the Pulmonary Dysfunction After Cardiac Surgery. Rev Bras Cir Cardiovasc; 2008.
Critical Care Therapy and Respiratory Care Section. Incentive Spirometry Guide. Clinical Center NIH; 2011.
Overend TJ, Anderson CM, Lucy SD, et al. The Effect of Incentive Spirometry on Postoperative Pulmonary Complications: A Systematic Review. Chest; 2001.
Narayanan AL, Hamid SR, Supriyanto E. Evidence Regarding Patient Compliance with Incentive Spirometry Interventions After Surgery: A Systematic Literature Review. CJRT; 2016.
Cardiopulmonary Services. Incentive Spirometry Protocol. LSUHSC; 2011.
