Safety and Efficacy of Incentive Spirometer in Covid-19 Pneumonia; a Randomized Clinical Trial
学术急诊医学档案,
卷 12 编号 1 (2024),
1 十月 2024
,
第 e51 页
https://doi.org/10.22037/aaem.v12i1.2244
摘要
Introduction: Various treatment protocols have been recommended since the beginning of the COVID-19 pandemic and have gradually evolved. This study aimed to assess the effectiveness and safety of incentive spirometer exercise (ISE) in outcomes of hospitalized patients with moderate-to-severe COVID-19 pneumonia.
Methods: A 3-month single-blind, two parallel-armed randomized controlled trial was conducted at Imam Hossein Hospital, Tehran, Iran. Participants aged >18 years with documented COVID-19 pneumonia were randomly allocated to 2 groups of IS (ISE in addition to the usual treatment) and control (usual care alone). The IS group was also asked to perform ISE after discharge for three months. The primary outcomes were peripheral O2 saturation (SpO2), VBG parameters (pCO2, PH, HCO3), dyspnea level measured by Modified Borg Scale (MBS), length of hospital stay (LOS), and respiratory rate (RR). Secondary outcomes included mortality rate, intubation rate (IR), and ICU admission rate.
Results: A total of 160 eligible patients were randomly assigned to either the IS (n = 80) or control (n=80) groups. Although there were no significant differences in primary and secondary outcomes between the groups post-intervention, adjusted analysis showed that participants allocated to the IS group had significantly higher SpO2 levels and lower RR, MBS levels, and LOS. Also, the adjusted model analysis showed a marginal statistically significant difference between groups in secondary outcomes, such as IR, the 1-month mortality rate, and the 3-month mortality rate.
Conclusion: It seems that adding the ISE to usual care in the early treatment setting of COVID-19 patients resulted in a relatively significant increase in SpO2 levels, improved respiratory status, and marginally decreased LOS. Additionally, ISE minimally reduced ICU admissions and intubation rates, with no significant impact on in-hospital or long-term mortality in patients with COVID-19 pneumonia.
- SARS CoV-2
- chest physiotherapy
- COVID-19, clinical decisions, chronic conditions, respiratory conditions
- breathing exercises
- covid-19, pneumomediastinitis, ARDS
- Pneumonia
- critical care
##submission.howToCite##
参考
Jamil S, Mark N, Carlos G, Cruz CSD, Gross JE, Pasnick S. Diagnosis and management of COVID-19 disease. American journal of respiratory and critical care medicine. 2020;201(10):P19-P20.
Thomas P, Baldwin C, Bissett B, Boden I, Gosselink R, Granger CL, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. Journal of physiotherapy. 2020;66(2):73-82.
Nasserie T, Hittle M, Goodman SN. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: a systematic review. JAMA network open. 2021;4(5):e2111417-e.
Organization WH. Living guidance for clinical management of COVID-19: living guidance, 23 November 2021. World Health Organization; 2021.
He Z-f, Zhong N-s, Guan W-j. The benefits of pulmonary rehabilitation in patients with COVID-19. Eur Respiratory Soc; 2021.
Makic MBF. Prone position of patients with COVID-19 and acute respiratory distress syndrome. Journal of PeriAnesthesia Nursing. 2020;35(4):437-8.
Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, et al. Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection: a systematic review. JAMA network open. 2021;4(10):e2128568-e.
Yang L, Yang T. Pulmonary Rehabilitation for Patients with Coronavirus Disease 2019 (COVID-19), Chronic Diseases and Translational Medicine. 2020.
Alahmri F, Muaither S, Alsharhan H, Alotaibi S, Alotaibi H, Alsadi S. The effect of pulmonary rehabilitation on covid-19 patients. Phys Med Rehabil Res. 2020;5:1-4.
Fila E, Rocco I, Rocco G, Zuccon U, Ruberti E. Recommendations for the respiratory rehabilitation of hospitalized and discharged COVID-19 patients: A sistematic review. G Ital Med Lav Ergon. 2021;43:56-65.
Kader M, Hossain MA, Reddy V, Perera NKP, Rashid M. Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study. BMC Sports Science, Medicine and Rehabilitation. 2022;14(1):60.
Javaherian M, Shadmehr A, Keshtkar A, Beigmohammadi MT, Dabbaghipour N, Syed A, et al. Safety and efficacy of pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID study): A prospective, randomised, single-blind, controlled trial. Plos one. 2023;18(1):e0268428.
Zhu Y, Wang Z, Zhou Y, Onoda K, Maruyama H, Hu C, et al. Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy. Journal of physical therapy science. 2020;32(8):545-9.
Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, et al. Evidence-based national consensus: recommendations for physiotherapy management in COVID-19 in acute care Indian setup. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2020;24(10):905.
Battaglini D, Caiffa S, Gasti G, Ciaravolo E, Robba C, Herrmann J, et al. An experimental pre-post study on the efficacy of respiratory physiotherapy in severe critically III COVID-19 patients. Journal of clinical medicine. 2021;10(10):2139.
Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive spirometry: 2011. Respiratory care. 2011;56(10):1600-4.
COVID W. Clinical management: living guidance. OMS/2019-nCoV/Clinical/20211.85:659-63.
Kendrick KR, Baxi SC, Smith RM. Usefulness of the modified 0-10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. Journal of Emergency Nursing. 2000;26(3):216-22.
Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology. 2020;295(3):715-21.
Bargahi M, Rastgoo N, Aryanejad F, Esmaielzade S, Nemati R, Ghaebi M, et al. Effect of Balloon-Blowing on Dyspnea and Oxygenation in Hospitalized COVID-19 Patients: A Pilot Study. Acta Medica Iranica. 2022:338-44.
Zhu J, Chen C, Shi R, Li B. Correlations of CT scan with high-sensitivity C-reactive protein and D-dimer in patients with coronavirus disease 2019. Pakistan journal of medical sciences. 2020;36(6):1397.
Lan C-C, Hsieh P-C, Yang M-C, Su W-L, Wu C-W, Huang H-Y, et al. Early pulmonary rehabilitation of COVID-19 patients in an isolation ward and intensive care unit. Tzu Chi Medical Journal. 2023;35(2):137-42.
Ambrose AF, Kurra A, Tsirakidis L, Hunt KC, Ayers E, Gitkind A, et al. Rehabilitation and in-hospital mortality in COVID-19 patients. The Journals of Gerontology: Series A. 2022;77(4):e148-e54.
Verma CV, Arora RD, Mistry HM, Kubal SV, Kolwankar NS, Patil PC, et al. Changes in mode of oxygen delivery and physiological parameters with physiotherapy in covid-19 patients: a retrospective study. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2021;25(3):317.
Mistry HM, Natesan A, Verma CV. Early Intervention of Physiotherapy Helps to Reduce Hospital Stay and Improve Functional Capacity of Patients with Severe COVID–ARDS. Indian Journal of Medical Sciences. 2020;73(1):75.
Lazzeri M, Lanza A, Bellini R, Bellofiore A, Cecchetto S, Colombo A, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi archives for chest disease. 2020;90(1).
Righetti RF, Onoue MA, Politi FVA, Teixeira DT, Souza PNd, Kondo CS, et al. Physiotherapy care of patients with coronavirus disease 2019 (COVID-19)-a Brazilian experience. Clinics. 2020;75:e2017.
Seyller H, Gottlieb M, Colla J. A breath of fresh air: The role of incentive spirometry in the treatment of COVID-19. The American Journal of Emergency Medicine. 2021;48:369.
Sheth AR, Faraji M, Boparai S, Dhaliwal L, Kulkarni S. Judicious use of incentive spirometry in resource limited times of COVID-19 pandemic. The American Journal of Emergency Medicine. 2021;47:290.
- 摘要 ##plugins.themes.ojsPlusA.frontend.article.viewed##: 1327 ##plugins.themes.ojsPlusA.frontend.article.times##
- PDF (English) ##plugins.themes.ojsPlusA.frontend.article.downloaded##: 574 ##plugins.themes.ojsPlusA.frontend.article.times##
##plugins.themes.ojsPlusA.frontend.article.downloadstatastics##
##plugins.block.makeSubmission.linkLabel##
SJR
COPE
