Duration of Early Preoperative Incentive Spirometry and Its Impact on Postoperative Pulmonary Complications in Patients Undergoing Open-Heart Surgery
- VernacularTitle:開胸術前早期から開始するインセンティブスパイロメトリーの実施期間と術後呼吸器合併症
- Author:
Kyohei ISHIKAWA
1
;
Mio KASAI
2
;
Kenichi HASHIZUME
2
Author Information
- Keywords: incentive spirometry; prehabilitation; postoperative pulmonary complications
- From:Japanese Journal of Cardiovascular Surgery 2025;54(6):257-262
- CountryJapan
- Language:Japanese
- Abstract: Introduction: While some reports have described the use of incentive spirometry (IS) beginning a few days prior to cardiac surgery, there is a lack of studies investigating its implementation from an earlier preoperative period. Furthermore, the relationship between the duration of preoperative IS use and the incidence of postoperative pulmonary complications (PPCs) remains unclear. Therefore, this study aimed to clarify the impact of different durations of preoperative IS use on postoperative outcomes, particularly the incidence of PPCs. Methods: A total of 91 patients who underwent elective cardiac surgery at our institution were included. Preoperative IS instruction was provided, and the duration from the initiation of IS to the day of surgery was recorded. Patients were divided into two groups: the short-term IS group (≤14 days, n=17) and the long-term IS group (≥15 days, n=74). Postoperative outcomes and the incidence of PPCs were compared between the two groups. Results: Compared to the short-term IS group (n=17), the long-term IS group (n=74) had a significantly lower incidence of postoperative pulmonary complications (47.0% vs. 17.5%, p<0.05), and fewer days to achieve sitting (3 vs. 2 days), standing (4 vs. 4 days), and walking (6 vs. 4 days) (p<0.05). Additionally, the long-term group showed significantly better outcomes at discharge in terms of physical function (SPPB: 9 vs. 12), functional status (FSS-ICU: 33 vs. 35, p<0.01), and discharge disposition (transfer to another hospital: 35.2% vs. 9.4%, p<0.05). Conclusion: Initiating IS instruction more than two weeks prior to cardiac surgery may reduce the incidence of postoperative pulmonary complications and contribute to earlier mobilization and better postoperative physical function.
