Acute Respiratory Distress Sindromy
Conditions
Interventions
Experimental group: 25 patients in mechanical ventilation for 48 hours or more will be submitted to respiratory muscle training with electronic device twice a day, seven days a week. Hemodynamic and r
Procedure/surgery
Sponsors
Faculdade de Ciências Médicas da Universidade Estadual de Campinas
Faculdade de Ciências Médicas da Universidade Estadual de Campinas
Eligibility
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: Adequate gas exchange as indicated by a PaO2 above 60 mmHg while breathing with an FIO2 of 0.50 or less; hemodynamically stable for 24 hours prior to participation or requiring only minimal intravenous pressor agents (dobutamine or dopamine less than 5mcg/kg/min, phenylephrine less than 1 mcg/kg/min); be able to follow simple verbal directions related to inspiratory muscle strength testing and training; receiving assist control or SIMV (synchronized intermittent mandatory ventilation) or pressure support ventilation via a tracheostomy, pressure support ventilation less than 15 cmH2O and PEEP (positive end expiratory pressure) less than 10 cmH2O. Unable to sustain unsupported breathing for at least 24 consecutive hours following resolution of factor(s) precipitating respiratory failure.
Exclusion criteria
Exclusion criteria: Inadequate gas exchange as indicated by a PaO2 under 60 mmHg while breathing with 0.50 or less percentage of oxigen; be medically instable and unready to be weaned from the ventilator as determined by the attending physician; hemodynamically instable for 24 hours requiring intravenous pressor agents (dobutamine or dopamine upper than 5mcg/kg/min, phenyleprine upper than 1mcg/kg/min); receiving continuous sedation and mechanical ventilation; have any progressive neuromuscular disease such as amyotrophic lateral sclerosis, muscular dystrophy, multiple sclerosis, myasthenia gravis, or other neuromuscular disorder that would interfere with responding to inspiratory muscle training; have an anticipated life expectancy under 12 months; have a core temperature above 38.5°C; have a spinal cord injury above T8 and any skeletal pathology (scoliosis, flail chest, spinal instrumentation) that would seriously impair the movement of the chest wall and ribs; using any type of home mechanical ventilation support prior to hospitalization; body mass index upper than 40 kg/m2; require continuous sedative or analgesic agents that will depress respiratory drive or the ability to follow commands; excessive secretions (requiring suctioning more than once every hour).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Outcome: time reduction of mechanical ventilation, weaning and Intensive Care Unit stay. Method: comparison between experimental and control groups. Parameters: Maximum inspiratory pressure increased, decreased in Rapid Shallow Breathing Index (RSBI) and reduction of weaning days and Intensive Care Unit stay with inspiratory muscle training by electronic device. | — |
Secondary
| Measure | Time frame |
|---|---|
| The safety using eletronic device in critically ill patients will be verified through the hemodynamic changes during the respiratory muscle training. | — |
Countries
Brazil
Contacts
Public ContactAntonio Falcão
Faculdade de Ciências Médicas da Universidade Estadual de Campinas
Outcome results
None listed