Comparison of the Effect of Inhalation and Intermittent Inhalation-Exhalation Incentive Spirometry on Dyspnea Severity and Atelectasis in Patients undergoing Coronary Artery Bypass Graft

Background: Dyspnea and atelectasis after Coronary Artery Bypass Graft (CABG) are common and need nursing attention. Inhalation and exhalation incentive spirometry is recommended for preventing alveolar collapse and atelectasis. Objectives: This study aimed to compare different methods of incentive spirometry on dyspnea severity and atelectasis of the patients undergoing CABG. Methods: This randomized clinical trial study was conducted on 66 patients undergoing CABG admitted to the Intensive Care Unit (ICU) of Cardiac Surgery Department in Hamadan, Iran, in 2020. The patients were selected through convenient sampling and were divided into two groups through block permutation: inhalation incentive spirometry and intermittent inhalation-exhalation spirometry. Both groups performed incentive spirometry according to the instructions they had received for four days. Then, they were examined for dyspnea and atelectasis using the Borg scale and chest x-ray, respectively. Results: During the intervention, dyspnea significantly decreased in the intermittent inhalation-exhalation group relative to the inhalation group (P<0.05). Most patients in both inhalation (63.6%) and intermittent inhalation-exhalation (65.6%) groups had atelectasis; however, no significant differences were observed between the two groups (P=0.867). Conclusion: Incentive spirometry via intermittent inhalation-exhalation method was more effective on dyspnea compared to the inhalation method. Therefore, this method is recommended to patients and nurses to reduce pulmonary complications after CABG