IS Reduces Rib Fracture Complications

Chang Gung Medical Foundation

Status: Completed

Conditions: Hemothorax; Traumatic; Rib Fractures; Rib Trauma

Treatments: Device: incentive spirometer

Study type: Interventional

Funder types: Other

Identifiers

NCT04006587

CMRPG 2E0221

Details and patient eligibility

About

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.

Full 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.

Enrollment: 50 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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50 participants in 2 patient groups

IS intervention

Experimental group

Description:

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.

Treatment:

Device: incentive spirometer

control

No Intervention group

Description:

standard care without IS intervention