Comparison of the effect of incentive spirometry and deep breathing exercises on hemodynamic parameters of patients undergoing coronary artery bypass graft surgery: A Clinical Trial

Is Incentive Spirometry Superior to Standard Care in Postoperative Cardiac Surgery on Clinical Outcomes and Length of Hospital and Intensive Care Unit Stay? A Systematic Review with Meta-Analysis

“…Twenty-three reports of 22 studies were included in this systematic review [ 27 - 48 ] . Twenty-two publications were reported in full; from one clinical trial, only the abstract was reported.…”

“…The studies involved 1,677 patients, with ages ranging from 38.3 to 65 years [ 31 , 45 ] , sample sizes ranging from 16 to 270 participants [ 43 , 46 ] , and study follow-up time ranging from two days to hospital discharge ( Table 1 ) [ 33 , 39 , 40 , 42 ] . Regarding the characteristics of the surgery and intervention, 74% of patients underwent CABG, 48% of patients received treatment using volume-oriented IS, 39% of patients used flow-oriented IS, and three studies did not have enough information to determine whether the type of spirometer was flowor volume-oriented ( Table 2 ) [ 39 , 46 , 48 ] . The hospital LOS ranged from 6.5 to 12.5 days, and the length of ICU stay ranged from 2.61 to 6.87 days ( Table 3 ).…”

“…Among the included studies, in general, the PEDro score ranged from 2 to 7 points, with a mean and standard deviation of 4.5±1.1. For seven trials, the scores were not available on the PEDro platform, therefore, the scores were independently graded by two authors [ 27 , 39 , 42 - 44 , 47 , 48 ] . After the evaluation of the two authors, three inconsistencies were observed, one on item 11 and two on item 8 [ 27 , 42 , 44 ] .…”

“…On item 10, all studies met the criteria. In the classification of the PEDro scale, 16 (69.6%) studies were judged as having “fair” [ 24 , 27 , 28 , 30 , 31 , 35 , 37 - 44 , 47 , 48 ] , four (17.4%) as “good” [ 32 - 34 , 45 ] , three (13%) as “poor” [ 29 , 36 , 46 ] , and zero (0%) as “excellent” quality ( Table 5 ). Considering the low methodological rigor of the studies included in this review, we were not able to perform sensitivity analysis including only high-quality studies.…”

“…The Amin et al (2021) [ 47 ] study was not included in the PEF meta-analysis as it did not have sufficient extractable data. The Barkhordari-Sharifabad et al (2021) [ 48 ] study was not included in the SO 2 meta-analysis as it was unclear whether it used flow-oriented IS or volume-oriented IS.…”