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Incentive spirometry

Gregory Reychler, Valeska Uribe Rodriguez, Cheryl Elizabeth Hickmann, Bertrand Tombal, Pierre-François Laterre, Axel Feyaerts, Jean Roeseler
INTRODUCTION: Impairment of global and regional pulmonary ventilations is a well-known consequence of general anesthesia. Positive expiratory pressure (PEP) or incentive spirometry (IS) is commonly prescribed, albeit their efficacy is poorly demonstrated. The aim of this study was to assess the effects of PEP and IS on lung ventilation and recruitment in patients after surgery involving anesthesia using electrical impedance tomography (EIT). METHOD: Ten male subjects (age = 61...
February 27, 2018: Physiotherapy Theory and Practice
Mary Field, Krista Fong, Carol Shade
PURPOSE: Effective information exchange among healthcare providers is critical to the delivery of high quality care. Electronic visibility boards (EVB) are an established tool for improving health care efficiency and promoting communication between healthcare team members. DESIGN AND METHODS: Seattle Children's Hospital (SCH) sought to evaluate the use of EVBs as a tool to improve patient care quality, safety and flow in a pediatric inpatient setting. EVBs were placed on the cancer and surgical patient care units at SCH, and displayed data flowing directly from the electronic health record...
January 30, 2018: Journal of Pediatric Nursing
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Patient adherence is a critical factor for success of patient-administered therapies, including incentive spirometry (IS). Patient adherence with IS is not known, so we sought to evaluate providers'perspectives on the current state of IS adherence and elucidate possible factors hindering patient adherence. METHODS: Respiratory therapists (RTs) and nurses across the United States were surveyed via social media and online newsletters. Surveys were distributed to the relevant national RT and nursing societies: the American Association for Respiratory Care, the Academy of Medical-Surgical Nurses, the American Society of Peri-Anesthesia Nurses, and the American Association of Critical-Care Nurses...
January 23, 2018: Respiratory Care
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Incentive spirometry (IS) is widely used to prevent postoperative pulmonary complications, despite limited clinical effectiveness data and a lack of standardized use protocols. We sought to evaluate health care professionals' perspectives on IS effectiveness and use procedures. METHODS: An online survey was distributed via social media and newsletters to relevant national nursing and respiratory care societies. Attitudes concerning IS were compared between the American Association for Respiratory Care (AARC) and the nursing societies...
January 23, 2018: Respiratory Care
A Beningfield, A Jones
BACKGROUND: Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population. OBJECTIVE: To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD. DATA SOURCES: A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016...
December 5, 2017: Physiotherapy
Shilpa Jain, Nitya Bakshi, Lakshmanan Krishnamurti
Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
Adam E M Eltorai, Ashley L Szabo, Valentin Antoci, Corey E Ventetuolo, Jack A Elias, Alan H Daniels, Dean R Hess
Incentive spirometry (IS) is commonly prescribed to reduce pulmonary complications, despite limited evidence to support its benefits and a lack of consensus on optimal protocols for its use. Although numerous studies and meta-analyses have examined the effects of IS on patient outcomes, there is no clear evidence establishing its benefit to prevent postoperative pulmonary complications. Clinical practice guidelines advise against the routine use of IS in postoperative care. Until evidence of benefit from well-designed clinical trials becomes available, the routine use of IS in postoperative care is not supported by high levels of evidence...
December 26, 2017: Respiratory Care
Vipin Kumar Goyal, Suresh Kumar Bhargava, Birbal Baj
BACKGROUND: Fentanyl-induced cough (FIC) has a reported incidence of 13-65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. METHODS: This study enrolled 200 patients aged 18-60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration...
October 2017: Korean Journal of Anesthesiology
Maria Amélia Rodrigues, Lydia Masako Ferreira, Eliziane Nitz de Carvalho Calvi, Fábio Xerfan Nahas
Background: After abdominoplasty, patients experience decreased ventilatory function and increased intra-abdominal pressure (IAP). Breathing exercises are used during the pre- and postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications. Objectives: The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients. Methods: Thirty-three patients were divided into 2 groups...
June 28, 2017: Aesthetic Surgery Journal
Fredric M Pieracci, Suresh Agarwal, Andrew Doben, Adam Shiroff, Larwence Lottenberg, Sarah Ann Whitbeck, Thomas W White
PURPOSE: There are currently no evidence-based indications for surgical stabilization of rib fractures (SSRF) in patients without flail chest. The purpose of this survey was to identify patients for whom there is relative equipoise (operative vs. non-operative) in order to assist in designing a randomized clinical trial. METHODS: Members of the Chest Wall Injury Society were sent an online survey, in which 18 patient scenarios were presented. The baseline patient had ≥ three displaced, contiguous fractures and had no other contraindications for surgery...
February 2018: International Orthopaedics
Rachael H Summers, Taniya Sharmeen, Kate Lippiett, Kate Gillett, Carla Astles, Linh Vu, Mark Stafford-Watson, Anne Bruton, Mike Thomas, Tom Wilkinson
'Finding the missing millions' with chronic obstructive pulmonary disease became part of the Department of Health strategy for England in 2010. Targeted case-finding within primary care is one potential pro-active strategy, but currently little is known about the views of healthcare professionals on this approach. In this study, 36 healthcare professionals (12 GPs, 14 nurses, and 10 practice managers) from 34 UK practices participated in semi-structured telephone interviews about targeted case-finding. Interviews followed an interview guide, were audio-recorded, transcribed verbatim, coded and analysed using 'Framework Approach'...
August 29, 2017: NPJ Primary Care Respiratory Medicine
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, Jared M Newman, Gannon L Curtis, Pedro A Torres, Rafay Khan, Michael A Mont
INTRODUCTION: Pneumonia is the third most common postoperative complication. However, its epidemiology varies widely and is often difficult to assess. For a better understanding, we utilized two national databases to determine the incidence of postoperative pneumonia after various surgical procedures. Specifically, we used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Nationwide Inpatient Sample (NIS) to determine the incidence and yearly trends of postoperative pneumonia following orthopaedic, urologic, otorhinolaryngologic, cardiothoracic, neurosurgery, and general surgeries...
July 25, 2017: Surgical Technology International
Ana Fernandez-Bustamante, Jonathan Schoen, Marcos F Vidal Melo
No abstract text is available yet for this article.
October 1, 2017: JAMA Surgery
Haddon Pantel, Thomas Schnelldorfer, Dmitry Nepomnayshy
No abstract text is available yet for this article.
October 1, 2017: JAMA Surgery
Christie O Armstrong
No abstract text is available yet for this article.
June 2017: Nursing
Johann Paulo S Guzman, Nilo C Delos Santos, Edgar A Baltazar, Allan Troy D Baquir
We present a rare case of 32year old female with congenital diaphragmatic eventeration female presenting in an adult. She had symptoms of intermittent dyspnea and occasional epigastric discomfort. Patient had no previous history of trauma. Physical examination showed bowel sound involving the left hemithorax. Imaging modalities confirmed the diagnosis of a congenital left diaphragmatic eventeration. Patient underwent plication of the diaphragm using the abdominal approach. Intra-operatively, the left diaphragm was attenuated...
2017: International Journal of Surgery Case Reports
Íllia N D F Lima, Guilherme A F Fregonezi, Rêncio B Florêncio, Tânia F Campos, Gardênia H Ferreira
BACKGROUND: Stroke may lead to several health problems, but positive effects can be promoted by learning to perform physical therapy techniques correctly. OBJECTIVE: To compare two different types of observational practice (video instructions and demonstration by a physical therapist) during the use of incentive spirometry (IS). METHOD: A total of 20 patients with diagnosis of stroke and 20 healthy individuals (56±9.7 years) were allocated into two groups: one with observational practice with video instructions for the use of IS and the other with observational practice with demonstration by a physical therapist...
January 2017: Brazilian Journal of Physical Therapy
Levon H Utidjian, Alexander G Fiks, A Russell Localio, Lihai Song, Mark J Ramos, Ron Keren, Louis M Bell, Robert W Grundmeier
OBJECTIVE: To examine the effect of ambulatory health care processes on asthma hospitalizations. METHODS: A retrospective cohort study using electronic health records was completed. Patients aged 2-18 years receiving health care from 1 of 5 urban practices between Jan 1, 2004 and Dec 31, 2008 with asthma documented on their problem list were included. Independent variables were modifiable health care processes in the primary care setting: (1) use of asthma controller medications; (2) regular assessment of asthma symptoms; (3) use of spirometry; (4) provision of individualized asthma care plans; (5) timely influenza vaccination; (6) access to primary healthcare; and (7) use of pay for performance physician incentives...
December 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
P F S Chacon, C F Schon, V H L A Furtado, G L A M Signoretti, J P P Oliveira, A G Ribeiro, C D V Wanderley, A A R Diniz, H B Soares
Patients suffering from hypoventilation and pulmonary expansion deficit are at increased risk of developing pulmonary complications such as atelectasis, pneumonia or pleural effusion. These complications can increase the length of stay and spending on health, and generate long-term functional impairment. This study aims to produce a therapeutic alternative to the traditional method of lung re-expansion through incentive spirometry (IS) using the game therapy to build an innovative system. This system makes use of infrared and Bluetooth communication technology to associate the game therapy to EI...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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