Blowing in the Wind: Use ofIncentive Spirometry in Preventing Acute Respiratory Distress Syndrome for Patients with Moderate COVID

ABSTRACT

In December 2019, there was an outbreak of COVID-19. This is a pilot study which aims to evaluate whether the use of Incentive Spirometry(IS) has a clinical significance in preventing Acute Respiratory Distress Syndrome (ARDS) among moderate COVID patients. IS, a lung expansion technique, which promotes sustained maximal inspiration helping patients by improving ventilation/perfusion mismatch and alveolar-PaO2 gradient. Prospective study involving 10 moderate COVID patients, aged 18-59 years admitted from November 2021-February 2022. Five were assigned under exposed(IS users) and five under non-exposed(non-IS users) group. Data were extracted on demographics such as age, gender, BMI and pre-morbid health status. Day of illness, admission chest radiograph, Arterial Blood Gas (PaO2/FiO2 ratio), oxygen saturation, vital signs and symptoms were obtained. The primary outcome was development of ARDS, with secondary outcome of further worsening of pneumonia and PaO2/FiO2 ratio on the 4th hospital day, preventing desaturations and shorter hospital stay. Outcomes from the exposed group were compared to the non-exposed group. IS- users were found to have improved PaO2/FiO2 ratio, improved Chest X-ray findings, shorter hospital day and earlier improvement of symptoms. Hence, IS use can be utilized as part of the management of COVID-19 patients during the initial stage of illness to avoid progression to ARDS.