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- Abstract:
- Abstract of “Evaluating the utilization and effectiveness of incentive spirometry” by Adam E. M. Eltorai, Ph.D., Brown University, May 2018 Background: Incentive spirometers (IS) were developed to reduce atelectasis through sustained maximal inspiration. However, without IS use compliance data, effectiveness of IS cannot be determined. The objective of this study was to evaluate the impact of a use-tracking IS reminder on patient compliance and clinical outcomes. Methods: A single-center randomized superiority controlled trial enrolled patients undergoing coronary artery bypass grafting (CABG) surgery was completed. A use-tracking, IS add-on device was developed to record and timestamp patient inspiratory breaths above daily target volumes. The tracker device had an integrated, use-reminder bell that could sound every hour. All patients were prescribed IS as standard of care and received the tracker device attached to their IS. Patients were randomized by surgical urgency (elective vs. non-elective) and sex (male vs. female) with reminder bell ON (experimental group) or OFF (control group). IS utilization was recorded for the duration of the postoperative stay and compared between groups. The primary clinical outcome was change in radiographic atelectasis severity. Secondary respiratory and non-respiratory outcomes were evaluated. Results: A total of 145 per-protocol patients(77.2%(112/145) male; mean age of 68.7 years(95%CI:67.2-70.2)) were evaluated, with 74 OFF and 71 ON patients. Baseline medical and motivation-to-recover characteristics of the two groups were similar(p>0.05). Mean number of daily inspiratory breaths was greater in the ON group(35.4 vs. 17.1;p<0.0001). Percent of recorded hours with an inspiratory breath event was greater in the ON group(58.2% vs. 27.5%;p<0.0001). The bell did not affect nursing IS-related workload(p=0.3170). Despite no differences in first postoperative chest x-ray mean atelectasis severity scores(2.3 vs. 2.4;p=0.4786), mean atelectasis severity scores for final chest x-rays before discharge were significantly lower for ON than OFF(1.5 vs. 1.8;p=0.0350). Of those with early postoperative fevers, febrile duration was shorter for ON(3.2 vs. 5.2 hours;p=0.0366) and had lower peaks temperatures(100.7oF vs. 101.0oF;p=0.0072). Bell ON reduced median postoperative length of stay(7 vs. 6 days;p=0.0483) and intensive care unit length of stay for non-elective patients(4 vs. 3 days;p=0.0217). Discussion: The incentive spirometer reminder improved patient compliance, atelectasis severity, and length of stay, particularly for non-elective CABG patients. In certain patients, when used appropriately, IS may be clinically effective.
- Notes:
- Thesis (Ph. D.)--Brown University, 2018
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Citation
Eltorai, Adam E. M.,
"Evaluating the utilization and effectiveness of incentive spirometry"
(2018).
Molecular Pharmacology, Physiology, and Biotechnology Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/rp3q-4y76
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Molecular Pharmacology, Physiology, and Biotechnology Theses and Dissertations
Theses and Dissertations for the Molecular Pharmacology, Physiology, and Biotechnology department....