Incentive spirometry with expiratory positive airway pressure brings benefits after myocardial revascularization

Arq Bras Cardiol. 2010 Feb;94(2):230-5, 246-51, 233-8. doi: 10.1590/s0066-782x2010000200017.
[Article in English, Portuguese, Spanish]


Background: Patients undergoing coronary artery bypass graft (CABG) surgery have higher risk to develop pulmonary complications (PCs) such as atelectasis, pneumonia and pleural effusion. These complications could increase the length of hospital stay, resources utilization and also are associated with reduced quality of life and functional capacity a long term.

Objective: To test if the use of incentive spirometry (IS) associated with expiratory positive airway pressure (EPAP), after CABG surgery improves dyspnea, effort perceived and quality of life 18 months after CABG.

Methods: Sixteen patients submitted to a CABG, were randomized to a control group (n=8) or IS+EPAP group (n=8). The protocol of IS+EPAP was applied in the immediate postoperative period and following for more 4 weeks in the patient's home. Eighteen months after CABG, the strength of the respiratory muscle, the functional capacity, the lung function, the quality of life and the level of physical activity were evaluated.

Results: After six minute walk test (6-MWT), the score of the dyspnea (1.6+/-0.6 vs 0.6+/-0.3, P<0.05) and the perceived effort (13.4+/-1.2 vs 9.1+/-0.7, P<0.05) were higher in the control group, when compared with the IS+EPAP group. In quality of life evaluation, the domain related to the physical aspects limitations was better in IS+EPAP group (93.7+/-4.1 vs 50+/-17, P<0.02).

Conclusion: Patients that were submitted to IS+EPAP present reduction of dyspnea and lower effort sensation after the 6-MWT, and also a better quality of life 18 months after CABG.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Cross-Sectional Studies
  • Dyspnea / physiopathology
  • Dyspnea / prevention & control*
  • Exercise / physiology
  • Female
  • Humans
  • Lung / physiology
  • Lung Diseases / prevention & control
  • Male
  • Middle Aged
  • Myocardial Revascularization / adverse effects*
  • Myocardial Revascularization / rehabilitation
  • Positive-Pressure Respiration / methods*
  • Positive-Pressure Respiration / standards
  • Postoperative Complications / prevention & control*
  • Quality of Life*
  • Spirometry / methods