MECHANISMS OF INCENTIVE SPIROMETRY IN PREVENTING PULMONARY COMPLICATIONS AFTER LUNG RESUSCITATION: A NARRATIVE REVIEW

Background: Lung resuscitation, usually performed following mechanical ventilation weaning or post-cardiac arrest, but with that it also increases the risks of pulmonary complications including atelectasis, ventilator-associated pneumonia (VAP), and impaired gas exchange. Incentive spirometry (IS) facilitates sustained maximal inspiration to counteract these via alveolar recruitment and collateral ventilation improvement. Aims and Objectives: This narrative review was assessed the IS efficacy in preventing pulmonary complications after lung resuscitation, evaluating rates of complications, lung volumes, Length of stay, and safety compared to standard care. Methods: Electronic databases including PubMed, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched from database inception until January 2026. Results: After successful evaluation of 11 studies, results indicates that IS significantly lowered the risks of pulmonary complications. Volume-type IS was found to be superior to flow-type, yielding an average increase in forced vital capacity (FVC) of 12–18%  (p<0.01) by the third day. Results were most pronounced when patient compliance exceeded 70%. The physiological mechanisms identified include restored functional residual capacity (FRC), diaphragmatic reconditioning, improved ventilation–perfusion (V/Q) matching, and enhanced secretion clearance. Furthermore, high patient compliance (>70%) was identified as a critical predictor of reduced LOS. Discussion: Through mechano-transduction mediated inspiratory training, incentive spirometry demonstrates strong effectiveness and minimal risk in preventing postoperative pulmonary problems. Conclusion:  Incentive spirometry is a safe, cost-effective intervention that optimizes pulmonary recovery. There is need of substantial clinical support for integrating standardized IS protocols into early post-lung resuscitation care to mitigate secondary complications and facilitate ventilator weaning.