Comparison of flow and volume incentive spirometry on pulmonary function and exercise tolerance in open abdominal surgery

A randomized clinical trial

Amaravadi Sampapath Kumar, Gopapala Krishna Alaparthi, Alfred Joseph Augustine, Zulfeequer Chundaanveetil Pazpazhyaottayil, Anand Ramakrishna, Shyam Krishnan Krishnakumar

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim: To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods: A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results: Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups.The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Conclusion: Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.

Original languageEnglish
Pages (from-to)KC01-KC06
JournalJournal of Clinical and Diagnostic Research
Volume10
Issue number1
DOIs
Publication statusPublished - 01-01-2016

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Exercise Tolerance
Spirometry
Surgery
Motivation
Randomized Controlled Trials
Lung
Preoperative Period
Vital Capacity
Peak Expiratory Flow Rate
Respiratory mechanics
Respiratory Mechanics
Urban Hospitals
Forced Expiratory Volume
Random Allocation
India

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Clinical Biochemistry

Cite this

Kumar, Amaravadi Sampapath ; Alaparthi, Gopapala Krishna ; Augustine, Alfred Joseph ; Pazpazhyaottayil, Zulfeequer Chundaanveetil ; Ramakrishna, Anand ; Krishnakumar, Shyam Krishnan. / Comparison of flow and volume incentive spirometry on pulmonary function and exercise tolerance in open abdominal surgery : A randomized clinical trial. In: Journal of Clinical and Diagnostic Research. 2016 ; Vol. 10, No. 1. pp. KC01-KC06.
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Comparison of flow and volume incentive spirometry on pulmonary function and exercise tolerance in open abdominal surgery : A randomized clinical trial. / Kumar, Amaravadi Sampapath; Alaparthi, Gopapala Krishna; Augustine, Alfred Joseph; Pazpazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan.

In: Journal of Clinical and Diagnostic Research, Vol. 10, No. 1, 01.01.2016, p. KC01-KC06.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of flow and volume incentive spirometry on pulmonary function and exercise tolerance in open abdominal surgery

T2 - A randomized clinical trial

AU - Kumar, Amaravadi Sampapath

AU - Alaparthi, Gopapala Krishna

AU - Augustine, Alfred Joseph

AU - Pazpazhyaottayil, Zulfeequer Chundaanveetil

AU - Ramakrishna, Anand

AU - Krishnakumar, Shyam Krishnan

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N2 - Introduction: Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim: To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods: A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results: Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups.The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Conclusion: Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.

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