Incentive spirometry
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An incentive spirometer is a handheld
medical device A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...
used to help patients improve the functioning of their
lungs The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side ...
. By training patients to take slow and deep breaths, this simplified
spirometer A spirometer is an apparatus for measuring the volume of air inspired and expired by the lungs. A spirometer measures ventilation, the movement of air into and out of the lungs. The spirogram will identify two different types of abnormal ventilat ...
facilitates lung expansion and strengthening. Patients inhale through a mouthpiece, which causes a piston inside the device to rise. This visual feedback helps them monitor their inspiratory effort. Incentive spirometers are commonly used after surgery or other illnesses to prevent pulmonary complications.


Overview

Incentive spirometer is indicated for patients who have had any surgery that might jeopardize respiratory function, particularly surgery to the lungs, but also to patients recovering from
cardiac The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
or other surgery involving extended time under anesthesia and prolonged in-bed recovery. Under general anesthesia and inactivity, a patient's breathing may slow, causing air sacs in their lungs to not fully inflate.
Atelectasis Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct ...
can develop and, if unmanaged, lead to
pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severi ...
and postoperative fever. Pneumonia is a major lung complication associated with increased morbidity and mortality, length of hospital stay, and likelihood of hospital readmissions. In conjunction with breathing exercises and early mobility, incentive spirometry use is therefore beneficial for patients recovering from pneumonia or rib damage to help minimize the chance of fluid build-up in the lungs. Because of its role in pulmonary rehabilitation and inspiratory muscle training, this device may theoretically benefit patients with
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quickly ...
. It may be used as well by wind instrument players who want to improve their air flow.


Indications

Incentive spirometer is indicated for the following reasons: * Following abdominal or thoracic surgery to reduce risks of pulmonary complications including
atelectasis Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct ...
and pneumonia * Patients with prolonged immobilization and bed rest *
Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
*
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quickly ...
* Cystic Fibrosis *
Sickle Cell Anemia Sickle cell disease (SCD) is a group of blood disorders typically inherited from a person's parents. The most common type is known as sickle cell anaemia. It results in an abnormality in the oxygen-carrying protein haemoglobin found in red bl ...
* Mild to moderate
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...
* Traumatic rib fractures with subsequent complications of
hemothorax A hemothorax (derived from hemo- lood+ thorax hest plural ''hemothoraces'') is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax may include chest pain and difficulty breathing, while the clinical signs may incl ...
and
flail chest Flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall. Two of the symptoms of flail chest are chest pain and shortness of breath ...


Contraindications

While there are no absolute contraindications for spirometry use, inspiratory muscle training can worsen some existing medical conditions, including the following: * Recent or current respiratory tract infection *
Hemoptysis Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, a ...
of unknown origin *
Pneumothorax A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve i ...
* Emphysema, due to increased barotrauma * Thoracic, abdominal, or cerebral
aneurysms An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus ( ...
* Recent thoracic, abdominal, or eye surgery * Nausea, vomiting, or acute illness * Confusion or dementia * Undiagnosed hypertension


Usage

Patient starts in a seated upright position. Patient exhales completely before using device. The patient then places the mouthpiece into their mouth and seals their lips tightly around it. The patient breathes in from the device as slowly and as deeply as possible, then holds that breath in for 2–6 seconds. This provides back pressure that pops open alveoli. It has the same effect as that which occurs during yawning. An indicator piston driven by the patient's breathing provides a gauge of how well the patient's lungs (or lung if singular) are functioning, by indicating sustained inhalation vacuum. While the patient is holding their breath, the indicator piston will slowly return to the bottom of the column. Patient then removes the mouthpiece from their mouth and exhales normally. Coughing can be expected to clear the airway and lungs of mucus. Patients are encouraged to rest if they begin feeling dizzy. Generally, patients are encouraged to do many repetitions a day while measuring progress by way of advancing the movable gauge along the central column of the device as they improve.


Alternative approach for children

Traditional incentive spirometers can be more challenging for children due to compliance and submaximal effort. Age-appropriate devices including whistles, pinwheels, and bubble wands should be considered. These toys and activities reinforce proper breathing mechanics by stimulating deep inhalation and prolonged exhalation.


Additional images


See also

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References


External links

{{Commons category, position=left Medical equipment Respiratory therapy