RT Journal Article SR Electronic T1 Comparison of incentive spirometers on thoracoabdominal mechanics and inspiratory muscular activation in morbidly obese JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P1183 VO 40 IS Suppl 56 A1 Denise de Moraes Paisani A1 Cibele Cristine Berto Marques Da Silva A1 Adriana Claudia Lunardi A1 Desiderio Cano Porras A1 Renata Cleia Claudino Barbosa A1 Celso Ricardo Fernandes Carvalho YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/P1183.abstract AB Morbid obesity causes restriction on chest wall and increases work of breathing. Incentive spirometry has been widely used in clinical practice for lung expansion; however, the effect of volumetric (VIS) and flow-oriented IS (FIS) on thoracoabdominal mechanics and respiratory muscular activity in morbidly obese are poorly known. Objectives: To compare the distribution of pulmonary volumes and inspiratory muscular activity during use of VIS and FIS in morbidly obese. Methods: Thoracoadominal mechanics (optoeletronic plethysmography) was evaluated in 17 morbidly obese (43±11yrs, BMI=45±5Kg/m2) simultaneously with respiratory muscular activity (electromyography) during quiet and deep breathes either using VIS or FIS (randomized sequence). Lung volume was evaluated in total chest wall (CW) and its compartments: abdominal (ABD) and upper (URC) and lower (LRC) ribcage. Muscular activity was evaluated in the sternocleidomastoid (SCM), upper (UIC) and lower intercostal (LIC) muscles. One way repeated measures ANOVA with post hoc Newman Keuls test were used and significance level was set at 5%. Results: A greater chest wall volume was achieved using VIS compared with FIS (respectively, 1.98±0.7L vs 1.62±0.5L; p=0.02); however no difference was observed in all inspiratory evaluated muscles (SCM=21±19 vs 28±23 10-3mV; UIC=9±5 vs 12±12 10-3mV; LIC=6±2 vs 6±3 10-3mV; p>0.05). Furthermore, thoracoabdominal asynchrony was observed during use of FIS (phase angle= 37±38 vs 31±36; p<0.001) compared to VIS. Conclusions: VIS induces greater chest wall volume with lower thoracoabdominal asynchrony in morbidly obese; however, without difference in the inspiratory muscular activity.