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Example of an incentive spirometer. To use, place your mouth around the mouthpiece, breathe out slowly, and then inhale slowly only through your mouth as deeply as you can. Try to get the piston as high as you can while keeping the indicator between the arrows, and then hold your breath for 10 seconds. You can place your marker at the highest point you were able to get the piston, so you have a goal for the next time you use it. Illustration by Diego Sabogal

An incentive spirometer is a handheld medical device that measures the volume of your breath. It can help the lungs heal after surgery or in cases of lung disease and conditions that fill the lungs with fluid. Your doctor, surgeon, or nurse will give you specific instructions on how to use it.

Spirometers are commonly used at hospitals after surgeries or prolonged illnesses that lead to extended bed rest. Your doctor or surgeon may also give you a take-home spirometer after surgery.

In this article, we’ll look at who might benefit from using an incentive spirometer, break down how spirometers work, and explain how to interpret the results.

An incentive spirometer helps your lungs recover after surgery or lung illness, keeping them active and free of fluid.

A piston rises inside the device to measure your breath volume when you breathe from an incentive spirometer. A healthcare professional can set a target breath volume for you to hit.

Breathing slowly with a spirometer allows your lungs to inflate fully. These breaths help break up fluid in the lungs that can lead to pneumonia if it’s not cleared.

It’s important to know that the spirometer works when you inhale because of the resistance it places on your breath. In a way, it works similarly to a straw. Exhaling into the spirometer will not help your lungs. In addition, using it correctly can also help your diaphragm function better over time.

Next to the central chamber of your spirometer is a slider. This slider can be used to set a target breath volume. Your doctor will help you set an appropriate goal based on your age, health, and condition.

Your doctor, surgeon, or nurse will also give you specific instructions on using your incentive spirometer. The following is the general protocol:

Set up

  1. Begin by sitting on the edge of your bed or chair.
  2. Hold the incentive spirometer in an upright position.
  3. Breathe out normally.
  4. Place the spirometer mouthpiece in your mouth and close your lips tightly around it.

How to breathe

  1. Breathe in through your mouth as slowly and deeply as you can, causing the piston or ball to rise toward the top of the chamber.
  2. Hold your breath for 3–5 seconds or as long as possible.
    • If the spirometer has a goal indicator, use this to guide your breathing. If the indicator goes above the marked areas, slow your breathing down.
  3. Remove the mouthpiece from your mouth.
  4. Breathe out normally. The piston or ball will return to the bottom of the chamber.
  5. Rest for a few seconds, then repeat the steps 10 or more times.
    • Go slowly. Take some regular breaths between deep breaths to prevent lightheadedness.
    • Do this every 1–2 hours when you’re awake.
  6. After each set of 10 deep breaths, cough a few times to clear your lungs.

Additional tips

Some additional tips for using an incentive spirometer include:

  • If you’re able to get out of bed, walk around often.
  • Periodically take deep breaths and cough to clear your lungs.
  • Keep using the incentive spirometer according to your healthcare professional’s instructions.
  • If you have an incision on your chest or abdomen after surgery, place a pillow or a rolled-up towel firmly against the incision when you cough. This may help reduce pain.
  • Write down your score each time you use your spirometer. This can help you track your progress over time and also help your doctor understand your progress. Contact your doctor if you’re consistently missing your target.

If you’re having difficulty using the spirometer for any reason, including pain or frequency of use, talk with your healthcare professional. Get emergency help if you develop shortness of breath, cough up blood, or see fluid or blood coming from an incision site when you cough.

Research has found conflicting results on the effectiveness of using an incentive spirometer compared with other lung-strengthening techniques.

However, there is some evidence that it can help people after surgery because it can keep the lungs active during bed rest.

Keeping the lungs active with a spirometer is thought to lower the risk of developing complications like atelectasis, pneumonia, bronchospasms, and respiratory failure.

In addition, an incentive spirometer may help people with the following conditions:

  • rib fractures: Fracturing a rib can lead to numerous lung complications such as pneumothorax, lung contusion, and even respiratory failure. Research shows using an incentive spirometer can help reduce these complications and help the lungs work better.
  • pneumonia: Incentive spirometry is commonly used to break up mucus buildup that builds up in the lungs in people with pneumonia.
  • chronic obstructive pulmonary disease (COPD). COPD is a group of respiratory disorders that are most commonly caused by smoking. There’s no current cure, but quitting smoking, using a spirometer, and following an exercise plan can help manage symptoms.
  • cystic fibrosis: People with cystic fibrosis might benefit from using an incentive spirometer to clear fluid buildup. A 2015 study found that spirometry has the potential to reduce pressure in the chest cavity and lower the chance of central airway collapse.
  • other conditions: A doctor may also recommend an incentive spirometer for people with sickle cell anemia, asthma, multiple sclerosis, or atelectasis.

The main column of your incentive spirometer has a grid with numbers. These numbers are usually expressed in millimeters and measure the total volume of your breath.

The piston in the main chamber of the spirometer rises upward along the grid as you breathe in. The deeper your breath, the higher the piston rises. Next to the main chamber is an indicator that your doctor can set as a target.

There’s a smaller chamber on your spirometer that measures the speed of your breath. This chamber contains a ball or piston that bobs up and down as the speed of your breath changes.

The ball will go to the top of the chamber if you’re breathing in too quickly and will go to the bottom if you’re breathing too slowly.

Many spirometers have a line on this chamber to indicate the optimal speed.

Healthy values for spirometry vary. Your age, height, and physical or sexual attributes all play a role in determining what’s typical for you.

Your doctor will consider these factors when setting a goal for you. Consistently hitting a result higher than the goal set by your doctor is a positive sign.

The Centers for Disease Control and Prevention has a reference calculator you can use to get an idea of the typical values for your demographic. But this calculator isn’t meant for clinical use. Don’t use it as a replacement for your doctor’s analysis.

You may feel dizzy or lightheaded when breathing from your spirometer. If you feel like you’re going to faint, stop and take several typical breaths before continuing. If symptoms persist, contact your doctor.

You may want to call your doctor if you’re unable to achieve the goal or if you have pain when you breathe deeply. Aggressive use of an incentive spirometer can lead to lung damage.

The hospital may give a take-home incentive spirometer if you’ve recently had surgery.

You can also get a spirometer at some pharmacies, rural health clinics, and federally qualified health centers. Some insurance companies may cover the cost of a spirometer.

One 2018 study found the per-patient cost of using an incentive spirometer is between $65.30 and $240.96 for an average 9-day hospital stay in an intermediate care unit.

An incentive spirometer is a device that can help you strengthen your lungs.

Your doctor might give you a spirometer to take home after leaving the hospital after surgery. People with conditions that affect the lungs, like COPD, may also use an incentive spirometer to keep their lungs fluid-free and active.

Along with using an incentive spirometer, following good pulmonary hygiene may help you clear your lungs of mucus and other fluids.