Post-operative pulmonary complications (PPCs) have a major impact on patients and healthcare expenses. The goal of perioperative respiratory therapy is to improve airway clearance, increase lung volume, and mitigate atelectasis. Incentive spirometers (IS) are ubiquitously used to prevent atelectasis and PPCs-implementation of which requires substantial provider time and healthcare expenses. However, meta-analyses have demonstrated that the effectiveness of ISs is unclear due to poor patient compliance in past studies.

The goal of this investigation is evaluate the effectiveness of IS on post-operative clinical outcomes. The aims of this investigation are to evaluate 1) if IS use compliance can be improved by adding a use-recording patient reminder alarm, and 2) the clinical outcomes of the more compliant IS users vs. the less-compliant IS users.

Inclusion Criteria:

• Undergoes any cardiothoracic surgery
• Is transferred to the cardiothoracic surgery intermediate (step-down) unit at Rhode Island Hospital
• Already prescribed an incentive spirometer as standard-of-care
• Followed by any healthcare provider
• Ability to sign informed consent and comply with all study procedures including follow-up for up to 1 year

Exclusion Criteria:

• <18 years of age
• Vulnerable population who in the judgment of the investigator is unable to give Informed Consent for reasons of incapacity, immaturity, adverse personal circumstances or lack of autonomy.