Which intervention is most effective for preventing postoperative atelectasis?

• A. Incentive spirometry every hour while awake and early ambulation
• B. Postoperative chest physiotherapy only when needed
• C. Prolonged bed rest
• D. High-flow oxygen therapy without movement

Answer: (A)

Preventing postoperative atelectasis centers on keeping the lungs well expanded and promoting movement to prevent shallow breaths. Incentive spirometry provides a patient-driven way to take slow, deep breaths that expand collapsed or under-ventilated areas of the lung, re-open small airways, and improve ventilation–perfusion matching. Doing this every hour while awake ensures repeated lung inflation during the critical recovery period and helps counteract the shallow breathing that often follows surgery due to pain and immobility. Early ambulation further enhances this effect by increasing chest and diaphragmatic movement, promoting deeper breaths, aiding mucus clearance, and reducing venous stasis—all of which lowers the risk of atelectasis and improves overall oxygenation.

Postoperative chest physiotherapy can be helpful for clearing secretions when needed, but it isn’t as preventive as regular deep breathing and movement. Prolonged bed rest worsens atelectasis risk by promoting shallow breathing and poor lung expansion. High-flow oxygen by itself improves oxygen delivery but does not address the underlying issue of alveolar collapse from shallow breathing and immobility.