Impact of Incentive Spirometry in COPD Exacerbations: A Comparative Study

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality in Nepal, with acute exacerbations (AECOPD) leading to severe complications. This study explores the impact of incentive spirometry (IS) on clinical outcomes, arterial blood gases and hospital stay in AECOPD patients.

Methodology: This comparative study was conducted at a tertiary care center in Kathmandu, Nepal and involved 60 AECOPD patients, split into two groups: 30 receiving standard medical treatment (control) without IS and 30 using IS. Demographic and clinical information were recorded and key outcomes— arterial blood gases (ABGs), MMRC score, respiratory rate, oxygen saturation, and hospital stay—were measured after stabilization and at discharge. Statistical analysis used SPSS 22, with significance set at p<0.05.

Results: Both groups showed significant improvement in MMRC and oxygen saturation(p<0.001). However, the IS group also demonstrated a significant reduction in respiratory rate (26.73±2.52 to 21.07±2.11, p<0.001), unlike the control group (27.3±2.3 to 26.80±2.37, p=0.12) and had a shorter hospital stay (5.87±1.36 days vs. 8.56±1.99 days, p<0.001). The IS group also demonstrated significant improvements in ABG parameters from admission to discharge: pH (7.35±0.087 to 7.42±0.054, p<0.001), pCO2 (62.76±9.55 to 43.88±6.62, p<0.001), and pO2 (62.76±9.55 to 78.88±6.97, p<0.001), while the control group did not.

Conclusion: Incentive spirometry proved superior to medical treatment alone by significantly improving ABGs, respiratory rate and reducing hospital stay in AECOPD patients. These findings support IS as a cost-effective tool in AECOPD management, particularly in resource-limited settings like Nepal. Further research is recommended to validate these results.