Incentive spirometry. Prevention of pulmonary complications after abdominal surgery.

The postoperative period after laparotomy is characterized by a decrease in pulmonary volumes combined with a maldistribution of the ventilation and the perfusion. Together with manual techniques, intermittent pressure breathing and incentive spirometry have been suggested to maintain open alveoli and to prevent atelactasissis. The shortcomings related to the use of pressure-controlled devices include patient's resistance to the technique, overinflation of normal alveoli, excessive total ventilation, decrease in venous return and various gastrointestinal side effects. The incentive spirometry has been designed to promote sustained maximal inspirations and reproduce sighing mechanisms. The decrease in pleural pressure can result in high transpulmonary pressures. For many investigators, incentive spirometry represents a very easy and efficient method to prevent atelectasis.