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Effect of inspiratory muscle training on weaning from mechanical ventilation in acute respiratory failure

Abstract

Objective

This study aimed to evaluate the effect of inspiratory muscle training (IMT) on weaning time and success.

Patients and methods

This is a prospective, randomized clinical study conducted in an ICU. A total of 15 patients were trained by inspiratory muscle exercise twice per day and 15 patients did not go under training (control group). Training was conducted through tuning the ventilator sensitivity based on the patients’ maximal inspiratory pressure (MIP). The experimental group received IMT starting with an initial load of 30% of their MIP measured immediately after changing patients to pressure support mode of mechanical ventilation (MV) and increased up to 40% as tolerated by the patient. Training was conducted for 5 min, two sessions per day. In addition, these patients received usual care of MV patients. Sputum culture assessment for aerobic organisms was done immediately after intubation.

Results

This is a prospective randomized control study that collected data on 30 patients with acute respiratory failure. Patients were randomly arranged into two groups (control and experimental). The mean MIP before initiation of weaning in both group was 16cm H2O. There is a significant difference in the final mean MIP between the experimental group (23.27 cm H2O) and the control group (17.40 cm H2O). There is also significant shortening in the weaning time in the experimental group and less frequent likelihood of reintubation, which was recorded in two cases of control group.

Conclusion

The IMT during MV may assist in early weaning off MV among patients with acute respiratory failure, and also it improves the weaning success rate, with less frequent likelihood of reintubation.

References

  1. Sprague SS, Hopkins PD. Use of inspiratory strength training to wean six patients who were ventilator dependent. Phys Ther 2003;83:171–181.

    Article  Google Scholar 

  2. Boles JM, Bion J, Connors A, Pearl R, Herridge M, Melot C, et al. Weaning from mechanical ventilation. Statement of the Sixth International Consensus Conference on Intensive Care Medicine. Eur Respir J 2007;29:1033–1056.

    Article  Google Scholar 

  3. Celli BR. Respiratory muscle function. Clin Chest Med 1986; 7:567.

    CAS  PubMed  Google Scholar 

  4. Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care 2010;16:19–25.

    Article  Google Scholar 

  5. Choi J, Tasota FJ, Hoffman LA. Mobility interventions to improve outcomes in patients undergoing prolonged mechanical ventilation:a review of the literature. Biol Res Nurs 2008;10:21–33.

    Article  Google Scholar 

  6. Adler D, Dupuis-Lozeron E, Richard J-C. , Janssens J-P., Brochard L. Does inspiratory muscle dysfunction predict readmission after intensive care unit discharge? Am J Respir Crit Care Med 2014;190:347–350.

    Article  Google Scholar 

  7. Bissett B, Leditschke A, Neeman T, Boots R, Paratz J. Weaned but weary:one third of adult intensive care patients mechanically ventilated for 7 days or more have impaired inspiratory muscle endurance after successful weaning. Heart Lung 2015;44:15–20.

    Article  Google Scholar 

  8. Moodie LH, Reeve JC, Vermeulen N, Elkins MR. Inspiratory muscle training to facilitate weaning from mechanical ventilation:protocol for a systematic review. BMC Res Notes 2011; 4:283.

    Article  Google Scholar 

  9. Esteban A, Alia I, Ibnez J. Modes of mechanical ventilation and weaning. Chest 1994;106:1188–1193.

    Article  CAS  Google Scholar 

  10. Martin AD, Huang CH, Davenport PW. Effect of inspiratory muscle strength training on inspiratory motor drive and RREP early peak components. J Appl Physiol 2002;94:462–468.

    PubMed  Google Scholar 

  11. Saeed AM, El Assal GI, Hendawy MM, Ali TM. Role of ultrasound in assessment of diaphragmatic functionmin chronic obstructive pulmonary disease patients during weaning from mechanical ventilation. Egypt J Bronchol 2016;10:167–172.

    Article  Google Scholar 

  12. Martin AD, Davenport PW, Gonzalez-Rothi RJ, Baz MM, Banner MJ, Layon AJ, et al. Inspiratory muscle strength training improves maximal inspiratory pressure in difficult to wean patients. Am Thorac Soc Int Conference 2007; 3:964.

    Google Scholar 

  13. Cader SA, de Souza Vale RG, Castro JC, Bacelar SC, Biehl C, Gomes MCV, et al. Inspiratory muscle training improve maximal inspiratory pressure and may assist weaning in older intubated patients. J Physiother 2010;56:171–177.

    Article  Google Scholar 

  14. Caruso P, Denari SDC, Ruiz SAL, Bernal KG, Manfrin GM, Friedrich C, et al. Inspiratory muscle training was ineffective in mechanically ventilated critically ill patients. Clinics 2005;60:479–484.

    Article  Google Scholar 

  15. Elbouhy MS, Abdelhalim HA, Hashem AMA. Effect of respiratory muscles training in weaning of mechanically ventilated COPD patients. Egypt J Chest Dis Tuberc 2014;63:679–687.

    Article  Google Scholar 

Download references

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Correspondence to Ahmed M. Ewis MD.

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Ewis, A.M. Effect of inspiratory muscle training on weaning from mechanical ventilation in acute respiratory failure. Egypt J Bronchol 12, 461–466 (2018). https://doi.org/10.4103/ejb.ejb_9_18

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