Summary
A preliminary assessment of the effectiveness of the Bartlett-Edwards incentive spirometer was made using it as part of the post-operative treatment of 34 patients after open-heart surgery. Its effects on atelectasis were assessed by measuring vital capacity, arterial oxygen tensions, clinical signs and radiological changes. It was found that vital capacity fell after surgery to 41.5 per cent of the pre-operative level, but this rose after the use of the incentive spirometer by an average of 15.5 per cent. Arterial oxygen tensions were unaltered by the use of the incentive spirometer. Temperature, pulse and respirations were of little help in the early diagnosis of atelectasis, but all patients who were still pyrexic four days after operation showed radiological evidence of atelectasis. The incidence of atelectasis demonstrated radiologically was total 84 per cent and plate 69 per cent, subsegmental 34 per cent and segmental 9 per cent.
The implications of these findings are discussed.
Résumé
Nous avons effectué une évaluation préliminaire de “ľIncentive Spirometer” de Bartlett-Edwards chez 34 opérés ayant subi une chirurgie à cœur-ouvert. Son influence sur ľatélectasie pulmonaire, au point de vue prévention ou évolution, a été évaluée au moyen de mesures des capacités vitales, des Pao2, des signes cliniques etradiologiques.
Nous avons trouvé que la capacité vitale tombait après la chirurgie à 41.5 pour cent du niveau pré-opératoire; elle remontait ďenviron 15 pour cent — utilisant ce spiromètre. Les Pao2 n’étaient cependant pas modifiées par ľusage du spiromètre. La température, le pouls et la fréquence de la respiration étaient peu contributoires au diagnostic précoce de ľatélectasie, mais tous les patients qui présentaient encore de la température quatre jours après ľintervention, avaient des signes radiologiques ďatélectasie. Ľincidence radiologique ďatélectasie était de 84 pour cent.
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Gale, C., Sanders, D.E. The bartlett-edwards incentive spirometer: A preliminary assessment of its use in the prevention of atelectasis after cardio-pulmonary bypass. Canad. Anaesth. Soc. J. 24, 408–416 (1977). https://doi.org/10.1007/BF03005115
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DOI: https://doi.org/10.1007/BF03005115