Role of Incentive Spirometry in Trauma Patients Managed with Tube Thoracostomy

Abstract

Objectives: To assess the role of incentive spirometry in trauma patients managed with tube thoracostomy in preventing postoperative pulmonary complications. Trauma injury accounts for 30% of all life years lost in the U.S.4 Chest trauma constitutes the major part of trauma. The majority of chest trauma requires careful surveillance and no surgical intervention. Tube thoracostomy may be required in the treatment of chest trauma. Incentive spirometer as a mechanical device helps in the lung expansion and encourages the residual collection either fluid or air to come out of the pleural space and drain it out through the chest tube. Materials and Methods: The study was conducted on patients coming with chest trauma to accident and emergency department of Civil Hospital Karachi, from January 2013 till July 2014. A total of 100 patients with chest trauma admitted through A&E department were enrolled in this research after taking written consent for tube thoracostomy and agreed to be the part of this research protocol. After assessment and consent the patients underwent tube thoracostomy under local anesthesia. The patients were divided into two groups by envelope technique, group A (n=50), who were advised to use incentive spirometer post procedure and the other was group B (n=50) who were not advised the use of incentive spirometer. Both the groups were then managed on same protocol of antibiotics and pain killers and were observed for the recovery in terms of removal of chest tube. Results: Out of a total of 100 patients, 68% were males and 32% were females. 73 % of the patients were young ranging from 21 to 50 years of age with the peak incidence of 31% in the age group of 31-40 years of age. The length of hospital stay was with mean of 5 days in group A, as compared to the length of the stay in group B is a mean of 8.5 days. Out of 100 patients 8 patient developed drain site infection [group A, n=2(25%), group B n=6(75%)]. 4 patients developed empyema thorax [group A, n=1(25%), group B, n=3(75%)]. Conclusion: The study shows that the use of incentive spirometer reduces the post operative pulmonary complications, length of hospital stay and also the cost and morbidity related to it. Incentive spirometer is a cost effective device to be used in post operative patients with no harmful effects.