Incentive spirometry versus active cycle of breathing technique: effect on chest expansion and flow rates in post abdominal surgery patients

Background: The patients undergoing abdominal surgery has characteristic post-operative mechanical abnormality in respiration like restrictive pattern of ventilation. Spontaneous deep breaths to restore functional residual capacity are abolished by pain. Incentive spirometry (IS) promotes frequent maximum inspiratory effort and is used for the prophylaxis and treatment of respiratory complications in post-surgery wards. Aim of the study was to compare the effect of incentive spirometry (IS) versus active cycle of breathing technique (ACBT) on flow rates and chest expansion in patients following abdominal surgery.Methods: It was prospective comparative interventional study. 90 patients posted for abdominal surgery and satisfying the inclusion criteria were included in the study. They were randomly divided through simple random sampling into two groups. Group A-IS group and Group B-ACBT group. Outcome measures were recorded as Peak inspiratory flow rate [PIFR], Peak expiratory flow rate [PEFR], Forced expiratory volume in 1 sec [FEV1] and chest expansion on pre and post-operative day five. Comparison of pre and post-operative day 1 and pre and post-operative day 5 was done using Wilcoxon signed Ranks Test for both group A and group B, further post hoc analysis was done by Tukey’s test at significance level of p<0.05. Inter as well as Intra group comparison was done. The comparison between group A and B for all the parameters was done by Mann- Whitney U test. At Statistical level of significance for Mann- Whitney U p<0.001.Results: Both IS and ACBT improve the peak flow rates and chest expansion in post abdominal surgery patients. Active cycle of breathing techniques is better technique compared to incentive spirometry in post abdominal surgery patients.Conclusions: ACBT (active cycle of breathing technique) has better results than incentive spirometry in post abdominal surgery cases

Medical research council dyspnoea score and forced expiratory volume in one second as the predictors of vertical climbing in chronic obstructive pulmonary disease patients

Background: Chronic obstructive pulmonary disease is a leading cause of chronic morbidity and mortality throughout the globe. MRC and FEV1 are related with 6MWD in COPD. But stair climbing is mechanically and physiologically different from walking. Dyspnoea is most often the limiting factor to staircase climbing. Hence the study is designed to correlate MRC dyspnoea score and FEV1 with vertical height climbed in COPD patients and to find out whether they are the predictors of vertical climbing in COPD patients.Methods: It was Prospective Cross sectional study. 50 COPD patients satisfying the inclusion criteria were underwent a stair climb test after recording their MRC dyspnoea score and FEV1. FEV1 was measured with mini Wright peak flow meter in sitting position. Vertical height of floor climbed, time taken to climb and recovery time was recorded.Results: A significant negative correlation and positive correlation was observed between vertical height climbed and MRC dyspnoea score (r= -0.76, p=0.001) and between vertical height climbed and FEV1 (r=0.59, p<0.001) respectively. On Multiple linear regression analysis, both are found to be the independent predictors of vertical height climbed by COPD.Conclusions: MRC and FEV1 correlated with vertical height climbed and found to be the independent predictors of vertical climbing in COPD patients. Vertical height climb (m) can be predicted with equation 12.94+5.58(FEV1) – 3.35(MRC)

Use of ozone in healing failed pectoralis major myocutaneous advancement flap

Infection of the sternotomy wound following cardiac surgery is quiet common. The PMMF (pectoralis major myocutaneous advancement flap) procedure is commonly used to treat non healing sternotomy wounds following CABG (coronary artery bypass graft) procedure. Ozone is used in the treatment of chronic, infected non healing wounds. A 65 year old female with a similar type of situation was treated with ozone in our study and the effects of ozone to significantly control infection and promote healing of the failed PMMF (pectoralis major myocutaneous advancement flap) graft can be well appreciated

Incentive spirometry versus active cycle of breathing technique: effect on chest expansion and flow rates in post abdominal surgery patients

Background: The patients undergoing abdominal surgery has characteristic post-operative mechanical abnormality in respiration like restrictive pattern of ventilation. Spontaneous deep breaths to restore functional residual capacity are abolished by pain. Incentive spirometry (IS) promotes frequent maximum inspiratory effort and is used for the prophylaxis and treatment of respiratory complications in post-surgery wards. Aim of the study was to compare the effect of incentive spirometry (IS) versus active cycle of breathing technique (ACBT) on flow rates and chest expansion in patients following abdominal surgery.Methods: It was prospective comparative interventional study. 90 patients posted for abdominal surgery and satisfying the inclusion criteria were included in the study. They were randomly divided through simple random sampling into two groups. Group A-IS group and Group B-ACBT group. Outcome measures were recorded as Peak inspiratory flow rate [PIFR], Peak expiratory flow rate [PEFR], Forced expiratory volume in 1 sec [FEV1] and chest expansion on pre and post-operative day five. Comparison of pre and post-operative day 1 and pre and post-operative day 5 was done using Wilcoxon signed Ranks Test for both group A and group B, further post hoc analysis was done by Tukey’s test at significance level of p&lt;0.05. Inter as well as Intra group comparison was done. The comparison between group A and B for all the parameters was done by Mann- Whitney U test. At Statistical level of significance for Mann- Whitney U p&lt;0.001.Results: Both IS and ACBT improve the peak flow rates and chest expansion in post abdominal surgery patients. Active cycle of breathing techniques is better technique compared to incentive spirometry in post abdominal surgery patients.Conclusions: ACBT (active cycle of breathing technique) has better results than incentive spirometry in post abdominal surgery cases

Use of ozone in healing failed pectoralis major myocutaneous advancement flap

Infection of the sternotomy wound following cardiac surgery is quiet common. The PMMF (pectoralis major myocutaneous advancement flap) procedure is commonly used to treat non healing sternotomy wounds following CABG (coronary artery bypass graft) procedure. Ozone is used in the treatment of chronic, infected non healing wounds. A 65 year old female with a similar type of situation was treated with ozone in our study and the effects of ozone to significantly control infection and promote healing of the failed PMMF (pectoralis major myocutaneous advancement flap) graft can be well appreciated