Incentive inspiration therapy: a review concerning volume and flow incentive spirometry techniques and Breath-Stacking

Abstract

Objectives: To revise the literature concerning the differences between incentive spirometers (IS) and the technique of Breath-Stacking (BS), comparing volume and flow incentive spirometers devices between themselves and both with the Breath-Stacking. Method: After a search on PUBMED data basis with the terms “incentive spirometry” and “Breath-Stacking”, we selected for this revision only the works that approached the differences between IS and the ones that compared those to the BS. Results: The volume incentive spirometers promote a more abdominal respiratory pattern with less use of respiratory accessorial muscles when compared to flow spirometers. A longer inspiration period and lower respiratory frequencies are also associated to the use of volume incentive spirometers. The Breath- Stacking causes pulmonary expansion up to volumes close to Total Pulmonary Capacity. According to the analyzed literature, significant higher volumes, as well as longer period of sustained inspiration were obtained during the use of Breath-Stacking when compared to spirometers. The Breath-Stacking also differs from spirometers concerning pulmonary ventilation pattern. The former being more directed to lung basis and periphery, which are more susceptible regions for post-operatory pulmonary complications. Conclusions: The success of Inspiration incentive therapy is influenced by the sensible choice of the most adequate instrument or technique for each patient