Critically Ill, Subacute Adult Patients, Mechanically Ventilation
Conditions
Keywords
sub-acute critical ill, mechanical ventilation, respiratory muscle training, respiratory muscle strength, rapid shallow breathing index
Brief summary
The goal of this clinical trial is to learn if inspiratory muscle training facilite the liberation of mechanical ventilation. The main questions it aims to answer are: Does inspiratory muscle training facilitate weaning from mechanical ventilation and enhance muscle strength in critically ill, subacute adult patients? The main questions it aims to answer are: Does pulmonary rehabilitation facilitate wwaning form mechanical patients? Does the intervention improve respiratory muscle strength and respiratory patterns? Participants received: Inspriatory muscle training twice daily for three consecutive weeks or until the subject no longer required ventilator support.
Detailed description
Patients on mechanical ventilation often experience rapid diaphragm atrophy on the second day, resulting in muscle fiber changes, respiratory muscle weakness. Clinical studies have explored enhancing diaphragm and respiratory muscle strength and endurance through inspiratory muscle, expiratory muscle, and combined respiratory muscle training. This study was to determine if inspiratory muscle training significantly facilitates liberation from mechanical ventilation and improves muscle strength when compared to without IMT among subacute critically ill adult patients.
Interventions
PROCEDUREInspiratory muscle training
A threshold inspiratory muscule device used a starting resistance set at 30% maximum inspiratory pressure, connecting to subject artificial airway. The subjects were then instructed to perform fast and forceful inspirations against added inspiratory resistance. The inspiratory muscle training was conducted twice daily over five consecutive days, followed by a two-day rest period. This regimen continued for three consecutive weeks or until the subject no longer required ventilator support.
PROCEDURERoutine care
Subjects received routine care without intervention.
Sponsors
Zuoying Armed Forces General Hospital
Kaohsiung Chang Gung Memorial Hospital,Taiwan
Chang Gung University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* requiring invasive mechanical ventilation for 2 days in an ICU
Exclusion criteria
* hemodynamic instability (heart rate 120 beats/min, unstable blood pressure, vasopressor infusion) * inadequate oxygenation (PEEP 8 cmH2O, FiO2 50%) * body temperature 38.5°C * sepsis * use of sedative infusion * steroid administration * home ventilator use before ICU admission
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of days until liberation from mechanical ventilation | Three weeks | A record of the number of days until liberation from mechanical ventilation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximum inspiratory pressure | Three weeks | Maximum inspiratory pressure was measured by having each subject exert maximum inspiratory force against a pressure gauge. |
| Maximum expiratory pressure | Three weeks | Maximum expiratory pressure was measured by having each subject exert maximum expiratory force against a pressure gauge. |
| Peak expiratory flow | Three weeks | The peak expiratory flow was measured using a respiratory mechanics monitor during three forceful expirations. |
| Peak inspiratory flow | Three weeks | The peak inspiratory flow was measured using a respiratory mechanics monitor during three forceful expirations. |
| Rapid Shallow breathing index | Three weeks | The RSBI was calculated by dividing the respiratory rate by the tidal volume |
Countries
Taiwan
Outcome results
None listed