Hyperinflation Rx

1
Hyperinflation Rx

• Incentive Spirometry
• Sustained Maximal Inspiration
• (SMI)

2
Incentive Spirometry

• Defn a technique using visual feedback to
  encourage patients to take slow, deep sustained
  inspirations
• Physiology decrease Ppl to create a
  transpulmonary gradient (PL)
• A man with normal lungs can sustain a PL of
• (-) 40 cm H2O for 5 to 15 secs, resulting in a
  TV gt 40 cc/Kg of IBW

3
Incentive Spirometry

• Goals
• Inflate lungs to at least 2-3X resting TV or
• 15 cc/Kg of IBW
• Improve cough mechanism
• Assess for acute pulmonary disease

4
Incentive Spirometry

• Indications
• Prophylaxis for post operative atelectasis
• Especially split chest and upper abdominal Sx
• Post operative atelectasis
• Visualized on chest x-ray
• Poor DBC with DNPC

5
Incentive Spirometry

• Criteria
• Patient should be cooperative and motivated
• Patient should be able to achieve at least
• 15 cc/Kg of IBW
• RR lt 25 breaths/minute

6
Incentive Spirometry

• Hazards/Complications
• Hyperventilation ? dizziness, tingling in the
  extremeties
• Barotrauma

7
Incentive Spirometry

• Contraindications
• Retained secretions
• Obtunded, comatose, uncooperative
• Unable to perform at least 15 cc/Kg of IBW