A Comparative Study of Incentive Spirometry and Positive Expiratory Pressure in Chest Trauma

After acceptance to participate in the study, patients will be computerized randomized into 2 groups:

• PEP group: positive expiratory pressure (PEP) breathing.
• INS group: inspiratory incentive spirometry breathing. The period between day 0 and 20 days post-trauma is considered an immediate phase of TT.

Once admitted, an initial evaluation by the doctor will be performed, and pleuro-pulmonary complications, the presence of respiratory failure, and pain control will be evaluated. The CP will perform a clinical, pain control, secretion and a dynamic costal examination. The medical treatment of pain control will begin, and the treatment of CP will begin, where it will be randomized in 2 groups: 1- PEP group: positive expiratory pressure (PEP) breathing the help of a PEP bottle device. 2- INS group: inspiratory incentive spirometry device (Coach®). Will be daily FR sessions, on weekdays. Upon admission, hospital discharge and post-discharge, radiological checks (simple radiography) will be performed and forced vital capacity will be measured with forced spirometry.

Inclusion criteria

• Chest trauma of 3 or more rib fractures with or without hemopneumothorax
• Signed informed consent.

Exclusion criteria

• Non-collaborating patients.
• Failure to submit a duly completed follow-up sheet for carrying out a minimum daily guideline (3 times a day) for CP treatment.
• Presence of respiratory failure at admission: PaO2 <60mmHg and / or PaCO2> 50mmHg.
• Medical indication for invasive or non-invasive ventilatory support.
• Presence of undrained pneumothorax.
• Complications that limit early mobility.