Key result
Incentive spirometry integrated into the ERAS protocol significantly reduced the incidence of postoperative pulmonary complications to 1.1% compared to 7.7% with conventional care.
Why the study?
Postoperative pulmonary complications impact morbidity after major abdominal surgery, but the role of incentive spirometry as an adjunct within ERAS protocols remains underexplored.
Does incentive spirometry within the ERAS framework reduce postoperative pulmonary complications, fluid administration, and length of stay in patients undergoing major abdominal surgery?
Does incentive spirometry within the ERAS framework reduce postoperative pulmonary complications, fluid administration, and length of stay in patients undergoing major abdominal surgery?
Absolute Event Rate: 1.1% vs 7.7%
p-value: p=0.030
Incentive spirometry as an adjunct to the ERAS protocol significantly reduces postoperative pulmonary complications, optimizes fluid management, and shortens hospital length of stay after major abdominal surgery.
Incentive spirometry within ERAS for abdominal surgery remains hypothesis-generating; randomized trials needed before practice change.
Background: Postoperative pulmonary complications (PPCs) significantly impact morbidity and healthcare burden after major abdominal surgeries. Enhanced Recovery After Surgery (ERAS) protocols have improved surgical outcomes, but the role of incentive spirometry (IS) as an adjunct in ERAS remains underexplored. Objective: To evaluate the efficacy of incentive spirometry within the ERAS framework in reducing PPCs, total fluid administration, and hospital length of stay (LOS) in patients undergoing major abdominal surgery. Methods: This quasi-experimental study was conducted at CMH Rawalpindi from June 2022 to March 2023 (ERC #393). A total of 182 patients (n = 91 per group), aged 18–60 years (ASA I–III), scheduled for elective major abdominal surgeries were included. Patients were allocated to the ERAS plus IS group (Group-IS) or conventional care group (Group-C). PPCs, perioperative fluid administration, and LOS were assessed using clinical and radiological parameters. Data were analyzed using SPSS (version 23), with statistical significance set at p ≤ 0.05. Results: PPC incidence was significantly lower in Group-IS (1.1%) than in Group-C (7.7%) (p = 0.03). Group-IS had significantly reduced perioperative fluid administration (1509 ± 178.23 mL vs. 2300 ± 256.23 mL, p = 0.000) and shorter LOS (1.44 ± 0.89 vs. 2.29 ± 0.87 days, p = 0.000). Conclusion: Incentive spirometry as part of the ERAS protocol significantly reduces PPCs, optimizes fluid management, and shortens LOS in major abdominal surgery, demonstrating clinical and economic benefits.
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Fawad et al. (2025) studied Major abdominal surgery (n=182). Incentive spirometry within ERAS protocol vs. Conventional perioperative care was evaluated on Incidence of postoperative pulmonary complications (PPCs) (p=0.030). Incentive spirometry integrated into the ERAS protocol significantly reduced the incidence of postoperative pulmonary complications to 1.1% compared to 7.7% with conventional care.
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