Title : Use of spirometry for chest training as part of ERAS guidelines in patients post rib fractures and major colorectal surgeries
Abstract:
Background: ERAS (Enhanced Recovery After Surgery) guidelines highlight early mobilization—including deep breathing exercises—as crucial for improved postoperative outcomes. Spirometry supports pulmonary recovery, but its use remains inconsistent in practice.
Aim: To assess compliance with spirometry use postoperatively and its impact on length of hospital stay and incidence of chest infections in patients with major colorectal surgeries or rib fractures.
Methods: A two-cycle audit was conducted in the General and Colorectal Surgery Department at Bedford Hospital (October 2024 – May 2025). Patients admitted with rib fractures or undergoing major colorectal surgeries were included. Both cycles lasted 3 months. The first cycle included 103 patients; the second, post-intervention, included 53. Data on spirometer use, length of hospital stay, and chest infections were collected.
Results: Spirometer use improved from 0% in the first cycle to 81.1% (43/53) in the second. All patients undergoing robotic colorectal resections received spirometers, with no postoperative chest infections.
- Length of stay reduced:
- Colorectal surgery: from 9 to 6 days (33.3%)
- Rib fractures: from 11 to 8 days (27.2%)
- Chest infections decreased from 9 to 4 cases (44%).
Conclusion: Improving spirometry use in line with ERAS guidelines significantly reduced hospital stay and postoperative chest infections. Routine implementation may enhance recovery in both surgical and trauma patients.