Postthoracotomy respiratory muscle mechanics during incentive spirometry using respiratory inductance plethysmography Journal Article


Authors: Melendez, J. A.; Alagesan, R.; Reinsel, R.; Weissman, C.; Burt, M.
Article Title: Postthoracotomy respiratory muscle mechanics during incentive spirometry using respiratory inductance plethysmography
Abstract: We undertook this study to characterize the postthoracotorny compartmental displacement and respiratory mechanical changes occurring during and after the performance of the incentive spirometry maneuver. We also evaluated the effect of recumbency angle on compartmental recruitment. Sixteen patients were randomized to perform incentive spirometry either at 30-degrees or 60-degrees recumbency angle. They were studied using respiratory inductance plethysmography to measure tidal volume, respiratory frequency, inspiratory time, rib cage motion/tidal volume ratio, inspiratory duty cycle, and inspiratory flow. Patients were studied before surgery and on postoperative days 1 and 3. Statistical analysis was accomplished using multiple measures ANOVA with post-hoe Student's t-tests when appropriate. Preoperative incentive spirometry augmented VT by increasing both VT/T1 and TI. Postoperatively, the incentive recruitment of VT was reduced, a result of a decrease in TI and TI/TTOT; VT/TI was unchanged. There was postoperative decrease of AB and AB/VT during incentive spirometry, greatest in the 60-degrees group. Our results characterize the nature of the respiratory recruitment afforded by incentive spirometry, before and after thoracotomy. We also found evidence of postthoracotomy diaphragmatic derecruitment during incentive spirometry exacerbated by a high recumbency angle.
Keywords: abdomen; lung; complications; care; humans; gas-exchange; upper abdominal-surgery; diaphragm function; rib cage
Journal Title: Chest
Volume: 101
Issue: 2
ISSN: 0012-3692
Publisher: American College of Chest Physicians  
Date Published: 1992-02-01
Start Page: 432
End Page: 436
Language: English
ACCESSION: WOS:A1992HC55700032
DOI: 10.1378/chest.101.2.432
PROVIDER: wos
PUBMED: 1735268
Notes: Source: Wos
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  1. Ruth A Reinsel
    78 Reinsel
  2. Michael E. Burt
    187 Burt