We read with interest the randomized clinical trial on incentive spirometry (IS) in patients undergoing coronary artery bypass grafting (CABG) by Eltorai and colleagues.1 The authors demonstrated that adding an hourly audible reminder for IS increases compliance. This is an interesting use of a device developed by the authors and does seem to improve compliance with a therapy that many believe decreases respiratory complications and promotes rehabilitation and discharge following any operation. However, the remainder of the study does require caution when interpreting the claimed improvement in outcomes.