Using an incentive spirometer reduces pulmonary complications in patients with traumatic rib fractures: a randomized controlled trial.
Adolescent
Adult
Aged
Aged, 80 and over
Female
Forced Expiratory Volume
Hemothorax
/ etiology
Humans
Length of Stay
Lung
/ physiopathology
Male
Middle Aged
Pneumothorax
/ etiology
Prospective Studies
Pulmonary Atelectasis
/ etiology
Rib Fractures
/ complications
Spirometry
/ economics
Thoracotomy
Treatment Outcome
Vital Capacity
Young Adult
Forced expiratory volume
Forced vital capacity
Incentive spirometer
Pulmonary complications
Rib fracture
Journal
Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253
Informations de publication
Date de publication:
30 Dec 2019
30 Dec 2019
Historique:
received:
09
08
2019
accepted:
28
11
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
22
9
2020
Statut:
epublish
Résumé
An incentive spirometer (IS) is a mechanical device that promotes lung expansion. It is commonly used to prevent postoperative lung atelectasis and decrease pulmonary complications after cardiac, lung, or abdominal surgery. This study explored its effect on lung function and pulmonary complication rates in patients with rib fractures. Between June 2014 and May 2017, 50 adult patients with traumatic rib fractures were prospectively investigated. Patients who were unconscious, had a history of chronic obstructive pulmonary disease or asthma, or an Injury Severity Score (ISS) ≥ 16 were excluded. Patients were randomly divided into a study group (n = 24), who underwent IS therapy, and a control group (n = 26). All patients received the same analgesic protocol. Chest X-rays and pulmonary function tests (PFTs) were performed on the 5th and 7th days after trauma. The groups were considered demographically homogeneous. The mean age was 55.2 years and 68% were male. Mean pretreatment ISSs and mean number of ribs fractured were not significantly different (8.23 vs. 8.08 and 4 vs. 4, respectively). Of 50 patients, 28 (56%) developed pulmonary complications, which were more prevalent in the control group (80.7% vs. 29.2%; p = 0.001). Altogether, 25 patients had delayed hemothorax, which was more prevalent in the control group (69.2% vs. 29.2%; p = 0.005). Two patients in the control group developed atelectasis, one patient developed pneumothorax, and five patients required thoracostomy. PFT results showed decreased forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV In conclusion, the use of an IS reduced pulmonary complications and improved PFT results in patients with rib fractures. The IS is a cost-effective device for patients with rib fractures and its use has clinical benefits without harmful effects. ClinicalTrials.gov, NCT04006587. Registered on 3 July 2019.
Sections du résumé
BACKGROUND
BACKGROUND
An incentive spirometer (IS) is a mechanical device that promotes lung expansion. It is commonly used to prevent postoperative lung atelectasis and decrease pulmonary complications after cardiac, lung, or abdominal surgery. This study explored its effect on lung function and pulmonary complication rates in patients with rib fractures.
METHODS
METHODS
Between June 2014 and May 2017, 50 adult patients with traumatic rib fractures were prospectively investigated. Patients who were unconscious, had a history of chronic obstructive pulmonary disease or asthma, or an Injury Severity Score (ISS) ≥ 16 were excluded. Patients were randomly divided into a study group (n = 24), who underwent IS therapy, and a control group (n = 26). All patients received the same analgesic protocol. Chest X-rays and pulmonary function tests (PFTs) were performed on the 5th and 7th days after trauma.
RESULTS
RESULTS
The groups were considered demographically homogeneous. The mean age was 55.2 years and 68% were male. Mean pretreatment ISSs and mean number of ribs fractured were not significantly different (8.23 vs. 8.08 and 4 vs. 4, respectively). Of 50 patients, 28 (56%) developed pulmonary complications, which were more prevalent in the control group (80.7% vs. 29.2%; p = 0.001). Altogether, 25 patients had delayed hemothorax, which was more prevalent in the control group (69.2% vs. 29.2%; p = 0.005). Two patients in the control group developed atelectasis, one patient developed pneumothorax, and five patients required thoracostomy. PFT results showed decreased forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV
CONCLUSIONS
CONCLUSIONS
In conclusion, the use of an IS reduced pulmonary complications and improved PFT results in patients with rib fractures. The IS is a cost-effective device for patients with rib fractures and its use has clinical benefits without harmful effects.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, NCT04006587. Registered on 3 July 2019.
Identifiants
pubmed: 31888765
doi: 10.1186/s13063-019-3943-x
pii: 10.1186/s13063-019-3943-x
pmc: PMC6937666
doi:
Banques de données
ClinicalTrials.gov
['NCT04006587']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
797Subventions
Organisme : Chang Gung Medical Foundation
ID : CMRPG 2E0221
Organisme : Chang Gung Medical Foundation
ID : CMRPG2F0212
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