Respiratory dysfunction in ventilated patients: can inspiratory muscle training help?

Bissett, B., Leditschke, I. A., Paratz, J. D. and Boots, R. J. (2012). Respiratory dysfunction in ventilated patients: can inspiratory muscle training help?. In: World Congress of Anaesthesiologists special edition. 15th WFSA World Congress of Anaesthesiologists, Buenos Aires, Argentina, (236-246). 25-30 March 2012.

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Author Bissett, B.
Leditschke, I. A.
Paratz, J. D.
Boots, R. J.
Title of paper Respiratory dysfunction in ventilated patients: can inspiratory muscle training help?
Conference name 15th WFSA World Congress of Anaesthesiologists
Conference location Buenos Aires, Argentina
Conference dates 25-30 March 2012
Proceedings title World Congress of Anaesthesiologists special edition   Check publisher's open access policy
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
Place of Publication Edgecliff, NSW, Australia
Publisher Australian Society of Anaesthetists
Publication Year 2012
Sub-type Fully published paper
ISSN 0310-057X
1448-0271
Volume 40
Issue 2
Start page 236
End page 246
Total pages 11
Collection year 2013
Language eng
Abstract/Summary Respiratory muscle dysfunction is associated with prolonged and difficult weaning from mechanical ventilation. This dysfunction in ventilator-dependent patients is multifactorial: there is evidence that inspiratory muscle weakness is partially explained by disuse atrophy secondary to ventilation, and positive end-expiratory pressure can further reduce muscle strength by negatively shifting the length-tension curve of the diaphragm. Polyneuropathy is also likely to contribute to apparent muscle weakness in critically ill patients, and nutritional and pharmaceutical effects may further compound muscle weakness. Moreover, psychological influences, including anxiety, may contribute to difficulty in weaning. There is recent evidence that inspiratory muscle training is safe and feasible in selected ventilator-dependent patients, and that this training can reduce the weaning period and improve overall weaning success rates. Extrapolating from evidence in sports medicine, as well as the known effects of inspiratory muscle training in chronic lung disease, a theoretical model is proposed to describe how inspiratory muscle training enhances weaning and recovery from mechanical ventilation. Possible mechanisms include increased protein synthesis (both Type 1 and Type 2 muscle fibres), enhanced limb perfusion via dampening of a sympathetically-mediated metaboreflex, reduced lactate levels and modulation of the perception of exertion, resulting in less dyspnoea and enhanced exercise capacity.
Keyword Breathing exercises
Ventilator weaning methods
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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Created: Fri, 16 Mar 2012, 15:45:05 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH