title: Incentive spirometry for the tracheostomy patient.
abstract: OBJECTIVE
  To determine the feasibility of developing and using a customized incentive spirometer device for patients who have undergone a tracheostomy procedure.
  
  
  METHODS
  The authors performed a prospective case series approved by the institutional review board.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Patients were eligible for participation if they were older than 18 years and had a new tracheostomy. Spirometry exercises were performed using a protocol adapted from the American Academy of Respiratory Care guidelines. Patient data were recorded, including age, sex, tobacco use, surgical procedure, time under general anesthesia, length of hospital stay, and time until ambulation. The details of the spirometry exercises were also recorded along with any complications that occurred.
  
  
  RESULTS
  An incentive spirometer was adapted for use with tracheostomy patients and received an investigational device exemption from the Food and Drug Administration. A total of 10 patients were enrolled (mean age 60 years). Sixty percent were current or former tobacco users, the mean anesthesia time was 9 hours, and 70% underwent a microvascular free flap reconstruction. Patients used the incentive spirometer for a mean of 1.6 days during the postoperative period, averaging 3.3 sessions per day and 6.8 breaths per session. The device was well tolerated by patients, and there were no complications associated with its use.
  
  
  CONCLUSIONS
  This study supports the feasibility of using a customized incentive spirometer for tracheostomy patients and establishes a safety profile for the device to be used in future studies.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, New York, USA. gregg.goldstein@uphs.upenn.edu
authors.forename: Gregg H
authors.initials: GH
authors.lastname: Goldstein
authors.forename: Alfred Marc
authors.initials: AM
authors.lastname: Iloreta
authors.forename: Bukola
authors.initials: B
authors.lastname: Ojo
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Malkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D001239:Inhalation; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010865:Pilot Projects; D011014:Pneumonia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000517:prevention & control; D013147:Spirometry / Q000295:instrumentation*; D014139:Tracheostomy / Q000009:adverse effects