Sandy C. Dass

Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


Zvart Onanian School of Nursing



Date of Original Version



Coronary artery bypass graft (CABG) surgeries are often associated with postoperative pulmonary complications such as atelectasis. This complication can lead to increased length of stay, morbidity, and mortality. There is substantial information about the impact of incentive spirometry postoperatively; however, the use of incentive spirometry preoperatively is understudied. This systematic review aims to determine if preoperative incentive spirometry use reduces the incidence of postoperative pulmonary complications after CABG surgery such as atelectasis, pleural effusions, pneumonia, and pulmonary embolism. Inclusion criteria included randomized controlled trials with the inclusion criteria of patients 18 years of age or older undergoing a CABG procedure, and preoperative use of incentive spirometry. Five studies met criteria and were included in this systematic review utilizing PRISMA guidelines and CASP tools. Descriptive data were collected from each study and a cross study analysis was conducted to compare all studies and assess the outcomes studied. Results of this systematic review demonstrate that preoperative teaching and appropriate use of incentive spirometry may reduce the incidence of postoperative pulmonary complications and length of stay. Implications of this study demonstrate the potential impact of the clinical nurse specialist (CNS) on preoperative evaluation and education of CABG patients to reduce postoperative pulmonary complications. Education regarding the preoperative use of incentive spirometry should be added to preoperative testing to decrease the incidence of pulmonary complications.

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