Hemothorax; Traumatic, Rib Fractures, Rib Trauma
Conditions
Keywords
incentive spirometer, Hemothorax; Traumatic, trauma, rib Fractures
Brief summary
The incentive spirometer (IS) is a mechanical device that helps lung expansion. It is commonly used to prevent postoperative lung atelectasis and decreased pulmonary complications in patients who received cardiac, lung, or abdomen surgery.This study aimed to explore the effect of the IS on the improvement of lung function and decrease in pulmonary complication rate in rib fractures patients.
Detailed description
Adult patients (\>18 years old) seen at our institution between June, 2014 until May, 2017 with traumatic rib fractures were included. For inclusion, a patient had to have at least one rib fracture as detected by chest X-ray (CXR) or computed tomography scan. We excluded patients with unconsciousness, history of chronic obstructive pulmonary disease, asthma, or an Injury Severity Score (ISS) ≥ 16. Patients were divided into two groups using a randomized envelope technique: in the study group, patients were advised to use the IS and in the control group patients did not received the IS. All patients were managed with the same oral analgesic protocol. A CXR was obtained on the 1st and 5th day of admission and performed by a radiologist. The Pulmonary Function Test (PFT) was administered on the 2nd and 7th day of admission and performed by a pulmonologist. A numeric rating scale (NRS) was used to define the severity of chest pain on the 1st and 5th day of admission.
Interventions
DEVICEincentive spirometer
patients were instructed how to use the IS in a seated or semi-seated position, and to maintain sustained maximal inspiration for 3-5 seconds before exhalation, ten times per hour, and for at least eight hours a day.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* at least one rib fracture as detected by chest X-ray (CXR) or computed tomography scan
Exclusion criteria
* unconsciousness, * history of chronic obstructive pulmonary disease * asthma * Injury Severity Score (ISS) ≥ 16
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pulmonary complication rate | 2 weeks after trauma | atelectasis, pneumonia, hemothorax, and pneumothorax |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1st lung function test | 2nd day of admission | forced vital capacity and forced expiratory volume in 1 second |
| 2nd lung function test | 7th day of admission | forced vital capacity and forced expiratory volume in 1 second |
| length of hospital stay | total hospital stay days up to 2 months after admission | total stay in hospital after trauma |
| 1st Pain score | 1st day of admission | Numerical Pain Rating Scale of chest pain, from 0 (no pain) to 10 (worst pain) |
| 2nd Pain score | 5th day of admission | Numerical Pain Rating Scale of chest pain, from 0 (no pain) to 10 (worst pain) |
Outcome results
None listed