An incentive spirometer (IS) is a hand-held medical device which is typically used after surgery or for people with chronic lung diseases like emphysema, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis to exercise the lungs and allow access to air in each corner of the lung.

The Bartlett-Edwards IS device was introduced in 1973 to incentivize deep breathing by offering visual light feedback when patients reached the target inspiratory volume.

Types of Incentive Spirometers

• Flow-oriented: They have a chamber with three interconnected columns in which lightweight plastic floats are placed. The chamber is connected to a flexible tube with a mouthpiece through which the patient inhales and attempts to raise the floats via inspiratory flow created by negative intrathoracic pressure.
• Volume-oriented: These devices have a flexible tube connected to a mouthpiece which, in turn, is connected to a chamber marked with volume measurements. When the patient inhales, a piston in the chamber rises relative to the maximum volume of air displaced.

Volume-oriented IS devices are clinically preferred because they require less effort to breathe.

How do incentive spirometers work?

Incentive spirometers exercise the lungs gently, causing the alveoli to stay inflated, and help keep them healthy. They retrain the lungs to take slow and deep breaths, especially after surgery or a COPD exacerbation, when it is too painful to breathe on one’s own. They help increase lung capacity and improve the ability to breathe.

Benefits of incentive spirometers

Incentive spirometers are useful in the following conditions:

• Emphysema
• Chronic bronchitis
• Asthma
• Bronchiectasis
• Major chest or abdominal surgery

Incentive spirometers benefit patients in the following ways:

• Clears lung infections – By inhaling and exhaling, the stale air in the lungs is cleared out along with any fluid or germs that may cause infections. Thus, patients are able to heal faster.
• Strengthens lungs before surgery – Some doctors may prescribe the use of IS devices before a patient presents for surgery to strengthen their lungs and reduce the risk of infection.
• Gently exercises lungs – IS devices keep the air sacs (alveoli) in the lungs inflated and measures how well the lungs fill up with air. Thus, the lungs are able to exchange oxygen and carbon dioxide effectively.
• Prevents lung collapse after surgery – Using an IS device after surgeries like lung cancer surgery or cardiac bypass surgery reduces the chances of atelectasis or lung collapse and post-operative pneumonia.

It takes time to get used to an IS device but the benefits are visible once the patient uses it regularly as directed. Tracking one’s progress, such as IS measurements, in a treatment journal helps keep up motivation.

Taking deep breaths are particularly painful after surgery where a chest or abdominal incision has been made, but it is necessary to strengthen the lungs. It may help to hold a pillow tightly to the incision area.

Although mixed results have been achieved with the use of IS devices after surgery, several physicians recommend it because it can be easily used at home without medical supervision and can be used by children as well.