Incentive Spirometry Prehabilitation Study
Incentive Spirometry Prehabilitation Study
Postoperative pulmonary complications (PPCs) are the most common complication following
 thoracic surgery. PPCs are associated with prolonged hospital stay, increased morbidity,
 mortality, ICU admission, and healthcare costs (Azhar, 2015). Current preoperative
 optimization in this patient group includes smoking cessation and management of Chronic
 Obstructive Pulmonary Disease with inhaled bronchodilators and inhaled steroids as indicated.
 There have been studies using preoperative incentive spirometry in patients undergoing
 laparotomy with conflicting results, but scant data on its use in patients undergoing
 one-lung ventilation (Tyson, et al., 2015; Cattano, et al., 2010). A study from 2013
 investigated the effectiveness of incentive spirometry in patients following thoracotomy and
 found conflicting results, without significant improvement in lung function or reduction in
 PPCs, but a larger difference in frequency of PPC was noted, indicating possible benefit to
 intervention and a need for further study (Agostini, et al., 2013). Volume-based incentive
 spirometry pre- and postoperatively has also been found to improve pulmonary function and
 diaphragm excursion in patients undergoing laparoscopic surgery (Alaparthi, et al., 2016).

 Patients customarily receive an incentive spirometer for use postoperatively in the PACU.
 There is scant data in the thoracic surgery population concerning prehabilitation by
 dispensing the incentive spirometer at the PACT evaluation.
Inclusion Criteria:

 -  Patients scheduled for thoracic surgery procedures involving one-lung ventilation

 -  open thoracotomy

 -  Video-assisted thoracoscopic surgery (VATS)

 -  Robotic-assisted thoracoscopic surgery (RATS)

 -  Procedures to include: Lung resection for any purpose, esophagectomy, thymectomy

 -  Patients undergoing esophagectomy performed by a general surgeon

 -  Patients willing and able to independently perform incentive spirometry

 Exclusion Criteria:

 -  Trauma patients

 -  Lung Volume reduction surgery (LVRS)

 -  In-Patients

 -  Patients not undergoing one-lung ventilation

 -  Patients undergoing thoracoabdominal aortic aneurysm repair

 -  Transhiatal esophagectomy (does not involve one-lung ventilation)

 -  Lung transplantation